Provider Demographics
NPI:1508139981
Name:FORRICH41, LLC
Entity Type:Organization
Organization Name:FORRICH41, LLC
Other - Org Name:JOINT REPLACEMENT PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:READY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:919-369-7252
Mailing Address - Street 1:111 HYANNIS DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-8336
Mailing Address - Country:US
Mailing Address - Phone:919-369-7252
Mailing Address - Fax:919-303-9199
Practice Address - Street 1:111 HYANNIS DR
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-8336
Practice Address - Country:US
Practice Address - Phone:919-369-7252
Practice Address - Fax:919-303-9199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8875251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC078UFOtherBLUE CROSS BLUE SHIELD