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Contact Information

GREG BERRY, CPO CPED
1102 BROWN ST
WASHINGTON, NC27889
 Phone: 252-940-1203
 Fax: 252-940-1206
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Customized Equipment

332BC3200X 87 All Other Suppliers
 

Orthotist

222Z00000X 55 Individual Certified Orthotist
 

Prosthetist

224P00000X 56 Individual Certified Prosthetist
Indicates primary specialty

NPI Profile & details for

NPI # 1639131592
Entity Organization
Organization subpart 1 Not specified
Enumeration date 04/05/2006
Last updated 09/30/2013 - About 13 years ago
Identifiers
License # CPO1835
NC Medicaid 7701327
VA Medicaid 9190511
Other 7795163 INDIVID EDS PED ORTHO
Other 7795164 INDIVID EDS PED PROSTH
NC Other 0482P BCBS
VA Other 384410 BCBS
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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