Provider Demographics
NPI:1881985273
Name:BROOKINS INC
Entity type:Organization
Organization Name:BROOKINS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED FITTER OF ORTHOTICS
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:CLEVELAND
Authorized Official - Last Name:HOMESLEY
Authorized Official - Suffix:
Authorized Official - Credentials:CFO CFTS
Authorized Official - Phone:704-735-2556
Mailing Address - Street 1:626 CENTER DR
Mailing Address - Street 2:P O BOX 368
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-3712
Mailing Address - Country:US
Mailing Address - Phone:704-735-2556
Mailing Address - Fax:704-735-9045
Practice Address - Street 1:626 CENTER DR
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-3712
Practice Address - Country:US
Practice Address - Phone:704-735-2556
Practice Address - Fax:704-735-9045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic FitterGroup - Single Specialty