Provider Demographics
NPI:1710927678
Name:LIMBCARE PROSTHETICS & ORTHOTICS, LLC
Entity Type:Organization
Organization Name:LIMBCARE PROSTHETICS & ORTHOTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PROSTHETIST & ORHTOTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:RODMAN
Authorized Official - Suffix:SR
Authorized Official - Credentials:CPO
Authorized Official - Phone:229-430-9778
Mailing Address - Street 1:2925 LEDO RD
Mailing Address - Street 2:UNIT 25
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-1266
Mailing Address - Country:US
Mailing Address - Phone:229-430-9778
Mailing Address - Fax:229-430-1347
Practice Address - Street 1:2925 LEDO RD
Practice Address - Street 2:UNIT 25
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-1266
Practice Address - Country:US
Practice Address - Phone:229-430-9778
Practice Address - Fax:229-430-1347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACPO1469335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier