Provider Demographics
NPI:1003845819
Name:CENTRAL BRACE & LIMB CO., INC.
Entity Type:Organization
Organization Name:CENTRAL BRACE & LIMB CO., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:M.
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HOBBS
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:317-925-4296
Mailing Address - Street 1:1901 N CAPITOL AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-1219
Mailing Address - Country:US
Mailing Address - Phone:317-925-4296
Mailing Address - Fax:317-924-7168
Practice Address - Street 1:500 E SPRINGHILL DR
Practice Address - Street 2:SUITE G
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4439
Practice Address - Country:US
Practice Address - Phone:812-232-2145
Practice Address - Fax:812-232-1416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100278910AMedicaid
IN100278910AMedicaid