Provider Demographics
NPI:1427456334
Name:LIMBCARE PROSTHETICS & ORTHOTICS OF GEORGIA INC
Entity type:Organization
Organization Name:LIMBCARE PROSTHETICS & ORTHOTICS OF GEORGIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:RODMAN
Authorized Official - Suffix:SR
Authorized Official - Credentials:CPO
Authorized Official - Phone:229-430-9778
Mailing Address - Street 1:2320 HAMILTON RD
Mailing Address - Street 2:STE B
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-8534
Mailing Address - Country:US
Mailing Address - Phone:706-576-3779
Mailing Address - Fax:706-576-6858
Practice Address - Street 1:2320 HAMILTON RD
Practice Address - Street 2:STE B
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-8534
Practice Address - Country:US
Practice Address - Phone:706-576-3779
Practice Address - Fax:706-576-6858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA21335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier