RICHARDSON PROSTHETICS & ORTHOTICS LLC NPI 1063030062

NPI Information

NPI: 1063030062
Provider Name: RICHARDSON PROSTHETICS & ORTHOTICS LLC
Classification: Durable Medical Equipment & Medical Supplies - 332BC3200X
Entity Type: Organization

Specialization: Customized Equipment

Address:
3210 PROSPERITY CHURCH RD STE 101
CHARLOTTE, NC
ZIP 28269
Phone: (704) 510-2204
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RICHARDSON PROSTHETICS & ORTHOTICS LLC is a customized equipment durable medical equipment medical supplies in Charlotte, NC. RICHARDSON PROSTHETICS & ORTHOTICS LLC NPI is 1063030062. The provider is registered as an organization entity type.

The provider's business location address is:

3210 PROSPERITY CHURCH RD STE 101
CHARLOTTE, NC
ZIP 28269-194
Phone: (704) 510-2204

The provider's authorized official is Rondell Richardson .
The authorized official title is Owner and has the following contact phone number (704) 510-2204.

The enumeration date for this NPI number is 7/7/2020 and was last updated on 11/3/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	335E00000X	Prosthetic/Orthotic Supplier				No
2	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	157863421	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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