Basic Information
| Provider Information | |||||||||
| NPI: | 1124192000 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HANGER PROSTHETICS & ORTHOTICS EAST INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4600 W ST STE A | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685032832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024668384 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4600 W ST | ||||||||
| Address2: | SUITE A | ||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685032832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024668384 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | PRICE | ||||||||
| AuthorizedOfficialFirstName: | SHERYL | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIR OF REIMBURSEMENT | ||||||||
| AuthorizedOfficialTelephone: | 5034938288 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | X | Suppliers | Durable Medical Equipment & Medical Supplies | 335E00000X | X | Suppliers | Prosthetic/Orthotic Supplier |
ID Information
| ID | Type | State | Issuer | Description | 1956060 | 05 | IA | MEDICAID | 9156552 | 05 | SD | MEDICAID |