GRANITE STATE ORTHOTICS AND PROSTHETICS, LLC; NPI #1750565479

Contact Information

GRANITE STATE ORTHOTICS AND PROSTHETICS, LLC

280 PLEASANT ST STE 3
CONCORD, NH 03301-2553

Phone: 603-228-7159
Fax: 603-225-4265
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Prosthetic/Orthotic Supplier	335E00000X	51	Medical Supply Company with Orthotist

Indicates primary specialty

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NPI Profile & details for GRANITE STATE ORTHOTICS AND PROSTHETICS, LLC

NPI Number 1750565479

LBN Legal business name GRANITE STATE ORTHOTICS AND PROSTHETICS, LLC

Authorized official GERARD FOWLER - (OWNER/PRACTITIONER)

Entity Organization

Organization subpart ¹ No

Enumeration date 12/18/2007

Last updated 04/20/2008 - About 18 years ago

Identifiers

NH	Medicaid	30761501
NH	Other	4665514	AETNA
NH	Other	12Y002242NH01	ANTHEM
NH	Other	2264576	CIGNA
NH	Other	706167	HARVARD PILGRIM

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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GRANITE STATE ORTHOTICS AND PROSTHETICS, LLC

Contact Information

Specialty

Prosthetic/Orthotic Supplier

NPI Profile & details for GRANITE STATE ORTHOTICS AND PROSTHETICS, LLC

Reviews for GRANITE STATE ORTHOTICS AND PROSTHETICS, LLC