MEDICARE: ORBIT MEDICAL INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	J05892	UT

General Provider Information

NPI Number	:	1053379172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORBIT MEDICAL INC

Provider Business Mailing Address
First Line	:	332 E 3300 S
Second Line	:	STE 200
City	:	SOUTH SALT LAKE
State	:	UT
Zip	:	84115-4456
Country	:	US
Telephone Number	:	801-713-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	332 E 3300 S
Second Line	:	STE 200
City	:	SOUTH SALT LAKE
State	:	UT
Zip	:	84115-4111
Country	:	US
Telephone Number	:	801-713-2020
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. BRANDON BLISS
Credential	:
Telephone Number	:	801-713-2020

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	08/15/2017

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