Provider Demographics
NPI:1427870310
Name:NORTHERN BRACE COMPANY INC
Entity type:Organization
Organization Name:NORTHERN BRACE COMPANY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:BINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-755-2300
Mailing Address - Street 1:26834 LAWRENCE
Mailing Address - Street 2:
Mailing Address - City:CENTER LINE
Mailing Address - State:MI
Mailing Address - Zip Code:48015-1262
Mailing Address - Country:US
Mailing Address - Phone:586-755-2300
Mailing Address - Fax:
Practice Address - Street 1:2934 E DUPONT RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-1667
Practice Address - Country:US
Practice Address - Phone:833-372-4709
Practice Address - Fax:833-372-6166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-30
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies