Provider Demographics
NPI:1306859368
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:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:M. MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
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 1:1901 N CAPITOL AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1219
Practice Address - Country:US
Practice Address - Phone:317-925-4296
Practice Address - Fax:317-924-7168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100278910CMedicaid
IN5866940001Medicare NSC