Healthcare Provider Details
I. General information
NPI: 1952122020
Provider Name (Legal Business Name): DEL BIANCO ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/22/2024
Last Update Date: 10/22/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1317 N BRIGHTLEAF BLVD STE A
SMITHFIELD NC
27577-7267
US
IV. Provider business mailing address
1031 W WILLIAMS ST STE 104
APEX NC
27502-3955
US
V. Phone/Fax
- Phone: 984-230-2577
- Fax: 888-635-6138
- Phone: 919-267-5284
- Fax: 888-635-6138
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
LEVI
DEL BIANCO
Title or Position: OWNER, MANAGING MEMBER
Credential: CPO
Phone: 919-740-8510