MEDICARE: TOTAL REHAB ORTHOTICS & PROSTHETICS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	1005584	NC
2	332BC3200X	Customized Equipment (DME)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0478V	OTHER	NC	BCBS
3	8238886	OTHER		UNITED HEALTHCARE

General Provider Information

NPI Number	:	1235133943
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL REHAB ORTHOTICS & PROSTHETICS INC

Provider Business Mailing Address
First Line	:	PO BOX 87067
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-7067
Country	:	US
Telephone Number	:	910-323-9016
Fax Number	:	910-486-8712

Provider Business Practice Location Address
First Line	:	2407 N ELM ST
Second Line	:
City	:	LUMBERTON
State	:	NC
Zip	:	28358-3658
Country	:	US
Telephone Number	:	910-618-1935
Fax Number	:	910-618-9920

Authorized Official
Title or Position	:	PRESIDENT / OWNER
Name	:	MRS. HEATHER FOUST MARCHANT
Credential	:	CMF
Telephone Number	:	910-824-0058

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	11/22/2021

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