Provider Demographics
NPI:1003932443
Name:ORTHOMED, LLC
Entity Type:Organization
Organization Name:ORTHOMED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:RICHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENSON
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:865-246-3333
Mailing Address - Street 1:314 ERIN DR
Mailing Address - Street 2:STE-103
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-6209
Mailing Address - Country:US
Mailing Address - Phone:865-246-3333
Mailing Address - Fax:865-246-3334
Practice Address - Street 1:314 ERIN DR
Practice Address - Street 2:STE-103
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-6209
Practice Address - Country:US
Practice Address - Phone:865-246-3333
Practice Address - Fax:865-246-3334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier