Healthcare Provider Details

I. General information

NPI: 1285666917
Provider Name (Legal Business Name): JAMES P RUBEL CPO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 08/03/2022
Certification Date: 08/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1636 TATE BLVD SE
HICKORY NC
28602-4244
US

IV. Provider business mailing address

PO BOX 9526
HICKORY NC
28603-9526
US

V. Phone/Fax

Practice location:
  • Phone: 828-326-7161
  • Fax: 828-326-9391
Mailing address:
  • Phone: 828-326-7161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License NumberCPO01474
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License NumberCPO01474
License Number StateNC
# 5
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberCPO01474
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: