Healthcare Provider Details

I. General information

NPI: 1508811100
Provider Name (Legal Business Name): AUGUSTA PROSTHETICS & ORTHOTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2068 WRIGHTSBORO RD
AUGUSTA GA
30904-4781
US

IV. Provider business mailing address

2068 WRIGHTSBORO RD
AUGUSTA GA
30904-4781
US

V. Phone/Fax

Practice location:
  • Phone: 706-733-8878
  • Fax: 706-733-4434
Mailing address:
  • Phone: 706-733-8878
  • Fax: 706-733-4434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: TINA MARIE RICE
Title or Position: ADMINISTRATOR
Credential:
Phone: 706-840-0743