Provider Demographics
NPI:1275369787
Name:ORTHOSC, LLC
Entity type:Organization
Organization Name:ORTHOSC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:JENIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:EDELEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-213-6149
Mailing Address - Street 1:210 VILLAGE CENTER BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-6706
Mailing Address - Country:US
Mailing Address - Phone:843-353-3460
Mailing Address - Fax:843-353-3461
Practice Address - Street 1:103 PROFESSIONAL PARK DRIVE
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526
Practice Address - Country:US
Practice Address - Phone:843-353-3460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty