Provider Demographics
NPI:1003391939
Name:EASTPOINT PROSTHETICS & ORTHOTICS, INC.
Entity Type:Organization
Organization Name:EASTPOINT PROSTHETICS & ORTHOTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ASSOCIATE
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-522-3278
Mailing Address - Street 1:310 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-8208
Mailing Address - Country:US
Mailing Address - Phone:252-522-3278
Mailing Address - Fax:252-522-3280
Practice Address - Street 1:2149 STUMBO RD
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OH
Practice Address - Zip Code:44906-1265
Practice Address - Country:US
Practice Address - Phone:419-512-9841
Practice Address - Fax:419-775-5861
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EASTPOINT PROSTHETICS & ORTHOTICS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-26
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies