Provider Demographics
NPI:1881835817
Name:AUGUSTA PROSTHETICS AND ORTHOTICS, INC
Entity Type:Organization
Organization Name:AUGUSTA PROSTHETICS AND ORTHOTICS, INC
Other - Org Name:AUGUSTA ORTHOTICS AND PROSTHETICS, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:RICE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:706-733-8878
Mailing Address - Street 1:2068 WRIGHTSBORO RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904
Mailing Address - Country:US
Mailing Address - Phone:706-733-8878
Mailing Address - Fax:706-733-4434
Practice Address - Street 1:535 NORTH COBB STREET
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061
Practice Address - Country:US
Practice Address - Phone:478-453-7327
Practice Address - Fax:478-451-0741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-21
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies