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General NPI Number Information
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NPI Number | 1346261492
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Entity Type | Organization
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Legal Business Name | RALPH LAMONT BAKER
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 08/20/2013
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Provider Practice Location Address
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Address Line | 428 N MAIN ST
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City | SALISBURY
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State | NC
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Zip | 28144-4349
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Country | US
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Telephone | 704-636-1850
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Fax | 704-637-7120
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Provider Business Mailing Address
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Address Line | 428 N MAIN ST
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City | SALISBURY
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State | NC
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Zip | 28144-4349
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Country | US
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Telephone | 704-636-1850
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Fax | 704-637-7120
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Authorized Official
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Title or Position | OWNER
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Name | MR. RALPH LAMONT BAKER SR.
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Credential |
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Telephone | 704-636-1850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State | NC
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