Organization
MERCADO ORTHOTICS & PROSTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AUDREY EDITH MOORE (OWNER)
(413) 923-7233
Entity
Organization
Contact information
Practice address
10 TEMPLE ST, SPRINGFIELD, MA 01105-1804
(413) 750-9915
(413) 750-9916
Mailing address
10 TEMPLE ST, SPRINGFIELD, MA 01105-1804
(413) 923-7233
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
12/11/2020
Last updated
04/13/2021
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