Provider Demographics
NPI:1447490321
Name:CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION INC
Entity type:Organization
Organization Name:CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOFSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-537-5600
Mailing Address - Street 1:3010 W AGUA FRIA FWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-3943
Mailing Address - Country:US
Mailing Address - Phone:623-474-3421
Mailing Address - Fax:623-544-5530
Practice Address - Street 1:1001 DIVISION ST
Practice Address - Street 2:SUITE B
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-1618
Practice Address - Country:US
Practice Address - Phone:623-474-3421
Practice Address - Fax:623-544-5530
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTER FOR ORTHOPEDIC RESEARCH AND EDUCATION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-04
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ102176Medicare PIN
AZZ132373Medicare PIN
AZ5550830009Medicare NSC