Healthcare Provider Details

I. General information

NPI: 1801184932
Provider Name (Legal Business Name): LIMBIONICS OF SANFORD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2011
Last Update Date: 12/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 WICKER ST
SANFORD NC
27330-4151
US

IV. Provider business mailing address

4441 SIX FORKS RD STE 106 PMB 258
RALEIGH NC
27609-5729
US

V. Phone/Fax

Practice location:
  • Phone: 919-777-0446
  • Fax: 919-777-0447
Mailing address:
  • Phone: 919-777-0446
  • Fax: 919-777-0447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateNC

VIII. Authorized Official

Name: MR. FRANK J. LOVERSO
Title or Position: PRESIDENT
Credential: C.P.
Phone: 919-441-0023