Organization
ORTHO PROS EXPRESS
Active
Other names
SELECT REHAB
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA F TRIMNAL DME (VP OPERATIONS)
(704) 921-2286
Entity
Organization
Contact information
Practice address
2205 DISTRIBUTION CENTER DR STE A, CHARLOTTE, NC 28269-4283
(704) 921-2286
(704) 921-2287
Mailing address
PO BOX 26828, CHARLOTTE, NC 28221-6828
(704) 921-2286
(704) 921-2287
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
10-0081963
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0395A
BLUE CROSS BLUE SHIELD
NC
01
—
282056
ANTHEM BCBS
VA
05
—
7701803
—
NC
05
—
91-1373-8
—
VA
05
—
DME958
—
SC
Enumeration date
09/12/2006
Last updated
08/22/2020
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