Provider Demographics
NPI:1003829342
Name:ORTHORX, INC.
Entity Type:Organization
Organization Name:ORTHORX, INC.
Other - Org Name:BREG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-795-5440
Mailing Address - Street 1:2382 FARADAY AVENUE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-7220
Mailing Address - Country:US
Mailing Address - Phone:760-795-5440
Mailing Address - Fax:214-501-0299
Practice Address - Street 1:400 MEADOWMONT VILLAGE CIR
Practice Address - Street 2:SUITE 425
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517
Practice Address - Country:US
Practice Address - Phone:919-929-5550
Practice Address - Fax:919-929-5572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01149332B00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7795288Medicaid
NC7704504Medicaid
NC7795288Medicaid