Provider Demographics
NPI:1356439814
Name:DELABY BRACE & LIMB CO INC
Entity Type:Organization
Organization Name:DELABY BRACE & LIMB CO INC
Other - Org Name:DELABY BRACE & LIMB CO INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:B
Authorized Official - Last Name:BENNER
Authorized Official - Suffix:
Authorized Official - Credentials:CPO, CPED
Authorized Official - Phone:910-299-0100
Mailing Address - Street 1:218 LISBON ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-4115
Mailing Address - Country:US
Mailing Address - Phone:910-299-0100
Mailing Address - Fax:910-299-0101
Practice Address - Street 1:218 LISBON ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-4115
Practice Address - Country:US
Practice Address - Phone:910-299-0100
Practice Address - Fax:910-299-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7700007Medicaid
NC7700007Medicaid