Provider Demographics
NPI:1154653145
Name:FLOYD BRACE COMPANY, INC.
Entity Type:Organization
Organization Name:FLOYD BRACE COMPANY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:A
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:843-412-3102
Mailing Address - Street 1:9213 UNIVERSITY BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9145
Mailing Address - Country:US
Mailing Address - Phone:843-614-6400
Mailing Address - Fax:843-873-7387
Practice Address - Street 1:138 BELLS HWY
Practice Address - Street 2:
Practice Address - City:WALTERBORO
Practice Address - State:SC
Practice Address - Zip Code:29488-2776
Practice Address - Country:US
Practice Address - Phone:843-782-3638
Practice Address - Fax:843-782-3637
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLOYD BRACE COMPANY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-02
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0237340007Medicare NSC