Provider Demographics
NPI:1811239346
Name:LIMB CENTER LLC
Entity Type:Organization
Organization Name:LIMB CENTER LLC
Other - Org Name:THE LIMB CENTER LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:F
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:623-326-0467
Mailing Address - Street 1:637 E COTTONWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-2023
Mailing Address - Country:US
Mailing Address - Phone:520-413-1554
Mailing Address - Fax:520-413-1549
Practice Address - Street 1:637 E COTTONWOOD LN
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-2023
Practice Address - Country:US
Practice Address - Phone:520-413-1554
Practice Address - Fax:520-413-1549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-22
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ6764700001Medicare NSC