Provider Demographics
NPI:1386718260
Name:HANGER PROSTHETICS & ORTHOTICS WEST INC
Entity type:Organization
Organization Name:HANGER PROSTHETICS & ORTHOTICS WEST INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-493-8288
Mailing Address - Street 1:PO BOX 650846
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0846
Mailing Address - Country:US
Mailing Address - Phone:602-426-8896
Mailing Address - Fax:602-426-8895
Practice Address - Street 1:4050 E COTTON CENTER BLVD
Practice Address - Street 2:SUITE 60
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-8861
Practice Address - Country:US
Practice Address - Phone:602-426-8896
Practice Address - Fax:602-426-8895
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANGER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-20
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ642307Medicaid
AZ642307Medicaid
0340220186Medicare NSC