Provider Demographics
NPI:1861626723
Name:EASTPOINT PROSTHETICS & ORTHOTICS, INC.
Entity Type:Organization
Organization Name:EASTPOINT PROSTHETICS & ORTHOTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MITCHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SUGG
Authorized Official - Suffix:
Authorized Official - Credentials:CPO, CPED, FAAOP
Authorized Official - Phone:252-522-3278
Mailing Address - Street 1:310 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-8208
Mailing Address - Country:US
Mailing Address - Phone:252-522-3278
Mailing Address - Fax:252-522-3280
Practice Address - Street 1:310 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504
Practice Address - Country:US
Practice Address - Phone:252-522-3278
Practice Address - Fax:252-522-3280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-07
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0193450Medicaid
NC1861626723OtherPARTNERS (BCBS)
NC1861626723OtherBCBS (TRAD, PPO, MC)
NC7795129Medicaid
NC7705029Medicaid
NC=========OtherTRICARE NORTH
NC1861626723OtherPARTNERS (BCBS)