Provider Demographics
NPI:1346552619
Name:ORTHOFIT INC.
Entity Type:Organization
Organization Name:ORTHOFIT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:E
Authorized Official - Last Name:GLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:BOCP
Authorized Official - Phone:980-505-3439
Mailing Address - Street 1:3581 CENTRE CIR STE 104
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-9742
Mailing Address - Country:US
Mailing Address - Phone:980-585-3571
Mailing Address - Fax:980-585-3572
Practice Address - Street 1:20387 WARRIOR DR
Practice Address - Street 2:
Practice Address - City:ONLEY
Practice Address - State:VA
Practice Address - Zip Code:23418-3059
Practice Address - Country:US
Practice Address - Phone:757-787-1242
Practice Address - Fax:757-787-1243
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOFIT INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-02
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BC3200X
VA335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment