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1184858169 NPI number — LIMBCARE PROSTHETICS AND ORTHOTICS OF GEORGIA INC

NPI Number: 1184858169
Health Care Provider/Practitioner: LIMBCARE PROSTHETICS AND ORTHOTICS OF GEORGIA INC

Information about “1184858169” NPI (LIMBCARE PROSTHETICS AND ORTHOTICS OF GEORGIA INC) exists in 1184858169 in HTML format HTML  |  1184858169 in plain Text format TXT  |  1184858169 in PDF (Portable Document Format) PDF  |  1184858169 in an XML format XML  formats.

NPI Number : 1184858169 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1184858169",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "LIMBCARE PROSTHETICS AND ORTHOTICS OF GEORGIA INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "511 W FORSYTH ST",
    "SecondLineMailingAddress": "SUITE A",
    "MailingAddressCityName": "AMERICUS",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "31709-3465",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "229-924-1620",
    "MailingAddressFaxNumber": "229-924-1623",
    "FirstLinePracticeLocationAddress": "511 W FORSYTH ST",
    "SecondLinePracticeLocationAddress": "SUITE A",
    "PracticeLocationAddressCityName": "AMERICUS",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "31709-3465",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "229-924-1620",
    "PracticeLocationAddressFaxNumber": "229-924-1623",
    "EnumerationDate": "05/06/2009",
    "LastUpdateDate": "11/03/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "RODMAN",
    "AuthorizedOfficialFirstName": "JOHN",
    "AuthorizedOfficialMiddleName": "P",
    "AuthorizedOfficialTitle": "CEO/OWNER",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "C.P.O.",
    "AuthorizedOfficialTelephoneNumber": "229-430-9778",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "335E00000X",
        "TaxonomyName": "Prosthetic/Orthotic Supplier",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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