Provider Demographics
NPI:1992015457
Name:CAPE FEAR ORTHOTICS & PROSTHETICS, INC.
Entity Type:Organization
Organization Name:CAPE FEAR ORTHOTICS & PROSTHETICS, INC.
Other - Org Name:CAPE FEAR O&P
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DIMITRI
Authorized Official - Middle Name:K
Authorized Official - Last Name:SLEEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-485-5811
Mailing Address - Street 1:PO BOX 58611
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-8611
Mailing Address - Country:US
Mailing Address - Phone:910-483-0933
Mailing Address - Fax:910-483-9622
Practice Address - Street 1:2100 OLD HIGHWAY 17 N
Practice Address - Street 2:SUITE 102
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-2242
Practice Address - Country:US
Practice Address - Phone:843-249-2500
Practice Address - Fax:843-249-2544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier