Provider Demographics
NPI:1548300510
Name:W.T. HINNANT ARTIFICIAL LIMB CO
Entity type:Organization
Organization Name:W.T. HINNANT ARTIFICIAL LIMB CO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:RALPH
Authorized Official - Last Name:RIFFLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-375-2587
Mailing Address - Street 1:3707 LATROBE DR STE 430
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-1361
Mailing Address - Country:US
Mailing Address - Phone:704-375-2587
Mailing Address - Fax:704-333-4429
Practice Address - Street 1:4455 DEVINE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-3611
Practice Address - Country:US
Practice Address - Phone:803-787-6911
Practice Address - Fax:704-333-4429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC540597Medicaid
SC540597Medicaid