Organization
DURRETT'S ORTHOTIC AND PROSTHETIC LLC
Active
Other names
Durrett's Orthotic & Prosthetic, LLC, Ron L Durrett
Organization subpart
No
Provider details
NPI number
Authorized official
SUZIE WARD (OWNER)
(859) 341-7688
Entity
Organization
Contact information
Practice address
20 MEDICAL VILLAGE DR, SUITE 100, EDGEWOOD, KY 41017-5401
(859) 341-7688
(859) 341-4476
Mailing address
20 MEDICAL VILLAGE DR, SUITE 100, EDGEWOOD, KY 41017-5401
(859) 341-7688
(859) 341-4476
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000032033
ANTHEM
KY
05
—
0662831
—
OH
01
—
100139
KY HEALTH SELECT
KY
01
—
1052964
PASSPORT
KY
01
—
21755
ABP-SOUTHGATE
KY
01
—
2433505000
PASSPORT ADVANTAGE
KY
01
—
427085
CCN-ONE SOURCE
KY
01
—
45000312
EPSDT
KY
01
—
66634
ABP-EDGEWOOD
KY
01
—
80444
NORTHWOOD
KY
01
—
8281414
AETNA HMO
KY
05
—
90420597
—
KY
01
—
K002945
CHAMPUS
KY
01
—
P0374
HOMELINK
KY
01
—
PO108
CHOICE CARE/HUMANA
KY
Enumeration date
12/29/2005
Last updated
12/19/2023
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