Provider Demographics
NPI:1801184932
Name:LIMBIONICS OF SANFORD, INC.
Entity Type:Organization
Organization Name:LIMBIONICS OF SANFORD, INC.
Other - Org Name:NORTH CAROLINA ORTHOTICS & PROSTHETICS OF SANFORD, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:LOVERSO
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:919-441-0023
Mailing Address - Street 1:4441 SIX FORKS RD STE 106
Mailing Address - Street 2:PMB 258
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-5729
Mailing Address - Country:US
Mailing Address - Phone:919-777-0446
Mailing Address - Fax:919-777-0447
Practice Address - Street 1:615 WICKER ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4151
Practice Address - Country:US
Practice Address - Phone:919-777-0446
Practice Address - Fax:919-777-0447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-11
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC332BC3200X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier