Provider Demographics
NPI:1679540918
Name:W.T. HINNANT ARTIFICIAL LIMB CO
Entity Type:Organization
Organization Name:W.T. HINNANT ARTIFICIAL LIMB CO
Other - Org Name:HINNANT PROSTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:RALPH
Authorized Official - Last Name:RIFFLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-375-2587
Mailing Address - Street 1:3707 LATROBE DR STE 430
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-1360
Mailing Address - Country:US
Mailing Address - Phone:704-375-2587
Mailing Address - Fax:704-333-4429
Practice Address - Street 1:3707 LATROBE DR STE 430
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1360
Practice Address - Country:US
Practice Address - Phone:704-375-2587
Practice Address - Fax:704-333-4429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC540597Medicaid
NC7700155Medicaid
NC7700155Medicaid
SC540597Medicaid