FAIRCHILD PEDORTHOTIC/ORTHOTIC SERVICES LLC NPI 1962683144

Prosthetic/Orthotic Supplier in Binghamton, NY

NPI 1962683144 Organization Prosthetic/Orthotic Supplier

About FAIRCHILD PEDORTHOTIC/ORTHOTIC SERVICES LLC

Fairchild Pedorthotic/orthotic Services Llc is a provider established in Binghamton, New York specializing in prosthetic/orthotic supplier. The NPI number of Fairchild Pedorthotic/orthotic Services Llc is 1962683144 and was assigned on November 2007. The practitioner's primary taxonomy code is 335E00000X with license number C0003702 (NY). The provider is registered as an organization and their NPI record was last updated 14 years ago. The authorized official of this NPI record is Mr. Edward Fairchild Co (Certified Orthotist)

NPI

1962683144

Provider NameFAIRCHILD PEDORTHOTIC/ORTHOTIC SERVICES LLC
Provider Location Address477 STATE ST COLONAIL PLAZA BINGHAMTON, NY 13901
Provider Mailing Address477 STATE ST COLONAIL PLAZA BINGHAMTON, NY 13901
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date11-16-2007
Last Update Date11-16-2007


Primary Taxonomy

Taxonomy Code335E00000X
ClassificationProsthetic/Orthotic Supplier
TypeSuppliers
License No.C0003702
License StateNY
Taxonomy DescriptionAn 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 function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

Business Address

FAIRCHILD PEDORTHOTIC/ORTHOTIC SERVICES LLC
477 STATE ST
COLONAIL PLAZA
BINGHAMTON, NY
ZIP 13901
Phone: (607) 348-0343
Fax: (607) 348-0347

Get Directions


Mailing Address

FAIRCHILD PEDORTHOTIC/ORTHOTIC SERVICES LLC
477 STATE ST
COLONAIL PLAZA
BINGHAMTON, NY
ZIP 13901
Phone: (607) 348-0343
Fax: (607) 348-0347



Authorized Official

Authorized Official NameMR. EDWARD FAIRCHILD CO
Authorized Official TitleCERTIFIED ORTHOTIST
Authorized Official Phone(607) 348-0343

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
4725040001MEDICARE NSC (07)NY
02408313MEDICAID (05)NY

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1992718712 EDWARD FAIRCHILD CO, CPED
Individual
Orthotic Fitter477 STATE ST COLONIAL PLAZA
BINGHAMTON, NY 13901
(607) 348-0343
1710332002OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC.
Organization
Pharmacy477 STATE ST
BINGHAMTON, NY 13901
(607) 584-9376

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.