Provider Demographics
NPI:1750346276
Name:RELIABLE PROSTHETICS AND ORTHOTICS LLC
Entity type:Organization
Organization Name:RELIABLE PROSTHETICS AND ORTHOTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MGR.
Authorized Official - Prefix:MR
Authorized Official - First Name:NICK
Authorized Official - Middle Name:M
Authorized Official - Last Name:FRISOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-638-8989
Mailing Address - Street 1:1314 COMMERCE DR STE B
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-2287
Mailing Address - Country:US
Mailing Address - Phone:252-638-8989
Mailing Address - Fax:252-638-5989
Practice Address - Street 1:1314 COMMERCE DR STE B
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2287
Practice Address - Country:US
Practice Address - Phone:252-638-8989
Practice Address - Fax:252-638-5989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCO003619335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5686710001Medicare NSC