CUSTOM ORTHOTICS OF NORTH CAROLINA LLC NPI 1932127396

NPI Information

NPI: 1932127396
Provider Name: CUSTOM ORTHOTICS OF NORTH CAROLINA, LLC
Classification: Durable Medical Equipment & Medical Supplies - 332BC3200X
Entity Type: Organization

Specialization: Customized Equipment

Address:
4125 BEN FRANKLIN BLVD
SUITE 180
DURHAM, NC
ZIP 27704
Phone: (919) 479-5990
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CUSTOM ORTHOTICS OF NORTH CAROLINA, LLC is a customized equipment durable medical equipment medical supplies in Durham, NC. CUSTOM ORTHOTICS OF NORTH CAROLINA, LLC NPI is 1932127396. The provider is registered as an organization entity type.

The provider's business location address is:

4125 BEN FRANKLIN BLVD
SUITE 180
DURHAM, NC
ZIP 27704-167
Phone: (919) 479-5990
Fax: (919) 479-8782

The provider's authorized official is Stephen Bradley Deal .
The authorized official title is Operations Manager, Orthotist and has the following contact phone number (919) 479-5990.

The enumeration date for this NPI number is 7/17/2006 and was last updated on 8/22/2020.

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	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment	C18399	NORTH CAROLINA	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	046P3	OTHER	NORTH CAROLINA	BCBS PROVIDER NUMBER
2	7704266	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: 11/14/2023

NPI Synchronization or Removal

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