MEDICARE: THE O'BRYAN COMPANY 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
2	333600000X	Pharmacy
3	3336M0002X	Mail Order Pharmacy
4	3336C0003X	Community/Retail Pharmacy	PHY48206	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5600641	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1851302400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE O'BRYAN COMPANY INC

Provider Business Mailing Address
First Line	:	5151 GOLDEN FOOTHILL PKWY
Second Line	:	STE 140
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-9609
Country	:	US
Telephone Number	:	916-852-4222
Fax Number	:	916-852-0951

Provider Business Practice Location Address
First Line	:	5151 GOLDEN FOOTHILL PKWY
Second Line	:	STE 140
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-9609
Country	:	US
Telephone Number	:	916-852-4222
Fax Number	:	916-852-0951

Authorized Official
Title or Position	:	PRESIDENT
Name	:	AUBREY OBRYAN
Credential	:
Telephone Number	:	916-852-4222

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	08/05/2011

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Directions to “THE O'BRYAN COMPANY INC ” Practice Location

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