Provider Demographics
NPI:1427405919
Name:EMERGEORTHO, PA
Entity Type:Organization
Organization Name:EMERGEORTHO, PA
Other - Org Name:TRIANGLE ORTHOPAEDIC ASSOCIATES, PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ALVA
Authorized Official - Last Name:DIMMIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-220-5255
Mailing Address - Street 1:50 MACEDONIA CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28681-8414
Mailing Address - Country:US
Mailing Address - Phone:828-635-8430
Mailing Address - Fax:828-635-7309
Practice Address - Street 1:50 MACEDONIA CHURCH RD
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28681-8414
Practice Address - Country:US
Practice Address - Phone:828-635-8430
Practice Address - Fax:828-635-7309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-16
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0401990030Medicare NSC