Provider Demographics
NPI:1740412733
Name:LABRIS, INC.
Entity Type:Organization
Organization Name:LABRIS, INC.
Other - Org Name:PERRUCA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARTRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-526-0051
Mailing Address - Street 1:13602 MACKERNUT CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1977
Mailing Address - Country:US
Mailing Address - Phone:301-526-0051
Mailing Address - Fax:301-249-4741
Practice Address - Street 1:13602 MACKERNUT CT
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1977
Practice Address - Country:US
Practice Address - Phone:301-526-0051
Practice Address - Fax:301-249-4741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies