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Organization
ALBEMARLE ORTHOTICS & PROSTHETICS, INC
Active
Organization
ALBEMARLE ORTHOTICS & PROSTHETICS, INC
Active
Other names
Coastal Carolina Prosthetics & Orthotics, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY S WILLIAMSON CPO (OWNER)
(252) 338-3002
Entity
Organization
Contact information
Practice address
106 MEDICAL DRIVE, ELIZABETH CITY, NC 27909
(252) 338-3002
(252) 338-2902
Mailing address
106 MEDICAL DRIVE, ELIZABETH CITY, NC 27909
(252) 338-3002
(252) 338-2902
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
NC
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0482P
BCBS
NC
01
—
384410
BCBS
VA
05
—
7701327
—
NC
05
—
9190511
—
VA
Enumeration date
03/14/2006
Last updated
12/09/2020
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