Provider Demographics
NPI:1386297679
Name:ORTHECO LLC
Entity type:Organization
Organization Name:ORTHECO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMPUTEE SUCCESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOPPLICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-492-0080
Mailing Address - Street 1:4105 UNION RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-1064
Mailing Address - Country:US
Mailing Address - Phone:314-492-0080
Mailing Address - Fax:314-461-1713
Practice Address - Street 1:4105 UNION RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-1064
Practice Address - Country:US
Practice Address - Phone:217-419-6075
Practice Address - Fax:314-461-1713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-17
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO7763970001Medicaid