SOUTHERN ORTHOTICS NPI 1639155021

NPI Information

NPI: 1639155021
Provider Name: SOUTHERN ORTHOTICS
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization
Address:
1601 ASHLEY CENTER
UNIT 88
VALDOSTA, GA
ZIP 31602
Phone: (229) 671-1161
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SOUTHERN ORTHOTICS is a durable medical equipment medical supplies in Valdosta, GA. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. SOUTHERN ORTHOTICS NPI is 1639155021. The provider is registered as an organization entity type.

The provider's business location address is:

1601 ASHLEY CENTER
UNIT 88
VALDOSTA, GA
ZIP 31602-055
Phone: (229) 671-1161
Fax: (888) 886-4887

The provider's authorized official is Eva Wynell Perez .
The authorized official title is Sole Proprietor and has the following contact phone number (229) 671-1161.

The enumeration date for this NPI number is 12/19/2005 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332B00000X	Durable Medical Equipment & Medical Supplies				Yes
2	335E00000X	Prosthetic/Orthotic Supplier				X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DMEPOS	OTHER		PROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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