Provider Demographics
NPI:1316585789
Name:ORTHOLOGIX, LLC
Entity Type:Organization
Organization Name:ORTHOLOGIX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-244-4100
Mailing Address - Street 1:2655 INTERPLEX DR STE 101
Mailing Address - Street 2:
Mailing Address - City:TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053
Mailing Address - Country:US
Mailing Address - Phone:800-659-9755
Mailing Address - Fax:215-244-4114
Practice Address - Street 1:2700 SILVERSIDE RD STE 5A
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-3724
Practice Address - Country:US
Practice Address - Phone:800-659-9755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier