Provider Demographics
NPI:1588896781
Name:HORIZON ORTHOTIC & PROSTHETIC EXPERIENCE INC
Entity type:Organization
Organization Name:HORIZON ORTHOTIC & PROSTHETIC EXPERIENCE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE/HR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:EWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-287-8433
Mailing Address - Street 1:11775 WEST 112TH ST. STE. 101
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2756
Mailing Address - Country:US
Mailing Address - Phone:913-663-4673
Mailing Address - Fax:913-338-4002
Practice Address - Street 1:4900 S. ARROWHEAD DR. STE. A
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-6990
Practice Address - Country:US
Practice Address - Phone:816-795-9600
Practice Address - Fax:816-795-9609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-20
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20192720335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO626314900Medicaid
KS200425630AMedicaid
MO626314900Medicaid