Provider Demographics
NPI:1457595860
Name:ORTHOPCS
Entity Type:Organization
Organization Name:ORTHOPCS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:QUILLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-755-6777
Mailing Address - Street 1:100 RICE MINE ROAD LOOP STE 102
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2423
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:205-342-2609
Practice Address - Street 1:100 RICE MINE ROAD LOOP STE 102
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2423
Practice Address - Country:US
Practice Address - Phone:865-755-6777
Practice Address - Fax:205-342-2609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL47335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier