Country Cobbler, Ltd.

LBN: Country Cobbler, Ltd.
Country Cobbler, Ltd. is an health care organization with primary practice located at 3501 Oleander Dr Suite 11, Wilmington NC 28403-0824. The organization recently has only one registered license in Suppliers / Prosthetic/Orthotic Supplier, which is considered as the primary health care specialty. Country Cobbler, Ltd. can be contacted via phone (910) 772-9994, or through Mantey, Mark Allen via phone (910) 772-9994.

Contact Information

Primary practice address
3501 Oleander Dr Suite 11 Wilmington NC 28403-0824
Phone: (910) 772-9994
Fax: (910) 772-1262
Website:
Map and Directions
Authorized official contact:
Name: Mantey, Mark Allen
Phone: (910) 772-9994

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Prosthetic/Orthotic Supplier 335E00000X 00992 North Carolina

Profile Details

NPI number 1780646653
LBN Legal business name Country Cobbler, Ltd.
DBA Doing business as
Authorized official Mantey, Mark Allen
Entity Organization
Organization subpart 1 No
Enumeration date Apr 5th, 2006
Last updated Sep 18th, 2015 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780646653 NPPES
North Carolina MEDICAID 7704409

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