Organization
NORTH CAROLINA ORTHOTICS & PROSTHETICS OF ROANOKE RAPIDS, INC
Active
Organization
NORTH CAROLINA ORTHOTICS & PROSTHETICS OF ROANOKE RAPIDS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY JOHNCOUR (OWNER)
(919) 556-3402
Entity
Organization
Contact information
Practice address
725 HAMILTON ST, SUITE D, ROANOKE RAPIDS, NC 27870-2746
(252) 535-0077
(252) 535-0078
Mailing address
2717 LEIGHTON RIDGE DR, SUITE 100, WAKE FOREST, NC 27587-5987
(252) 535-0077
(252) 535-0078
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047C0
BCBS
—
05
—
7704534
—
NC
Enumeration date
10/25/2006
Last updated
08/14/2018
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