Provider Demographics
NPI:1760915722
Name:MYLIMBS PROSTHETICS & SUPPLIES
Entity Type:Organization
Organization Name:MYLIMBS PROSTHETICS & SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROSTHETIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBBIIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-401-5095
Mailing Address - Street 1:740 HWY 49
Mailing Address - Street 2:
Mailing Address - City:FLORA
Mailing Address - State:MS
Mailing Address - Zip Code:39071
Mailing Address - Country:US
Mailing Address - Phone:601-401-5095
Mailing Address - Fax:601-401-5096
Practice Address - Street 1:740 HIGHWAY 49
Practice Address - Street 2:SUITE Q
Practice Address - City:FLORA
Practice Address - State:MS
Practice Address - Zip Code:39071-9278
Practice Address - Country:US
Practice Address - Phone:601-401-5095
Practice Address - Fax:601-401-5096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC16081335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier