MEDICARE: LIMBCARE PROSTHETICS & ORTHOTICS LLC.

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	261QM1300X	Multi-Specialty Clinic/Center	CPO02238	AL

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

General Provider Information

NPI Number	:	1528157914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIMBCARE PROSTHETICS & ORTHOTICS LLC.

Provider Business Mailing Address
First Line	:	1350 LINDBERG DR
Second Line	:
City	:	SLIDELL
State	:	LA
Zip	:	70458-8054
Country	:	US
Telephone Number	:	985-726-9052
Fax Number	:	985-726-9053

Provider Business Practice Location Address
First Line	:	1350 LINDBERG DR
Second Line	:
City	:	SLIDELL
State	:	LA
Zip	:	70458-8054
Country	:	US
Telephone Number	:	985-726-9052
Fax Number	:	985-726-9053

Authorized Official
Title or Position	:	PROSTHETIST/ORTHOTIST
Name	:	MR. EDMOND JUDE RESTIVO JR.
Credential	:	CPO
Telephone Number	:	985-726-9052

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	08/22/2020

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