Provider Demographics
NPI:1659617694
Name:FENIX ORTHOPEDIC GEAR COMPANY
Entity Type:Organization
Organization Name:FENIX ORTHOPEDIC GEAR COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:LAVERNE
Authorized Official - Last Name:BROWNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-412-3259
Mailing Address - Street 1:713 E 65TH ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4408
Mailing Address - Country:US
Mailing Address - Phone:912-352-0765
Mailing Address - Fax:912-352-0789
Practice Address - Street 1:713 E 65TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4408
Practice Address - Country:US
Practice Address - Phone:912-352-0765
Practice Address - Fax:912-352-0789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-19
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies