Koebers Prosthetic & Orthotic Lab Inc. in Peoria - Prosthetic/orthotic Supplier
Koebers Prosthetic & Orthotic Lab Inc. - NPI 1700936234
Koebers Prosthetic & Orthotic Lab Inc. is a Prosthetic/orthotic Supplier in Peoria, Illinois. Koebers Prosthetic & Orthotic Lab Inc. practices all healthcare services and medical treatments related to Prosthetic/orthotic Supplier. The NPI Number for Koebers Prosthetic & Orthotic Lab Inc. is 1700936234. The last update date is 2018-07-30.
Koebers Prosthetic & Orthotic Lab Inc.'s current location address is 741 W Main St, Peoria, Illinois. You can contact this provider via phone number 8003345705 and fax number 8886636322. The mailing address for Koebers Prosthetic & Orthotic Lab Inc. is 741 W Main St, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Koebers Prosthetic & Orthotic Lab Inc. |
|---|---|
| Address | 741 W Main St, Peoria, Illinois |
| Phone Number | 8003345705 |
| Fax Number | 8886636322 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Goertzen Donald |
| Credentials | CPO |
| Telephone Number | 3096762276 |
NPI Number Detail
| NPI Number | 1700936234 |
|---|---|
| Provider Enumeration Date | 2007-01-10 |
| Last Updated Date | 2018-07-30 |
Provider Mailing Address Detail
| Address | 741 W Main St |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616061953 |
| Phone Number | 8003345705 |
| Fax Number | 8886636322 |
Provider's Primary Taxonomy Detail
| Speciality | Prosthetic/orthotic Supplier |
|---|---|
| Taxonomy | 335E00000X |
|
Definition: An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological f |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1680020 | IL | BLUE CROSS BLUE SHIELD |
Post Comment/ Review Below
What is the unique identifier code issued to Koebers Prosthetic & Orthotic Lab Inc. by the Centers for Medicare & Medicaid Services (CMS)?
The Koebers Prosthetic & Orthotic Lab Inc. has been assigned the NPI (National Provider Identifier) 1700936234. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical location address where Koebers Prosthetic & Orthotic Lab Inc.'s facilities are situated?
The facilities of Koebers Prosthetic & Orthotic Lab Inc. are physically located at the following address: 741 W Main St, Peoria, IL, 616061953.
What is Koebers Prosthetic & Orthotic Lab Inc.'s specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Koebers Prosthetic & Orthotic Lab Inc.'s specialized field of practice is Prosthetic/orthotic Supplier, and the corresponding taxonomy code that categorizes this area of specialization is 335E00000X.
On what date did Koebers Prosthetic & Orthotic Lab Inc. receive its 1700936234 assignment from the Centers for Medicare & Medicaid Services?
The Koebers Prosthetic & Orthotic Lab Inc. was assigned its 1700936234 on 2007-01-10, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the Koebers Prosthetic & Orthotic Lab Inc.'s details last updated?
The information pertaining to the Koebers Prosthetic & Orthotic Lab Inc., including its address, specialty, and other details, was most recently updated on 2018-07-30.
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