Healthcare Provider Details

I. General information

NPI: 1891013181
Provider Name (Legal Business Name): DEL BIANCO ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 02/10/2020
Certification Date: 02/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 W WILLIAMS ST STE 104
APEX NC
27502-3955
US

IV. Provider business mailing address

1031 W WILLIAMS ST SUITE 104
APEX NC
27502-3955
US

V. Phone/Fax

Practice location:
  • Phone: 919-267-5284
  • Fax: 888-635-6138
Mailing address:
  • Phone: 919-267-5674
  • Fax: 888-635-6138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier7705172
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name: JAMES LEVI DEL BIANCO
Title or Position: OWNER, MANAGING MEMBER
Credential: CPO
Phone: 919-740-8510