Healthcare Provider Details

I. General information

NPI: 1356513139
Provider Name (Legal Business Name): ORR MEDICAL ENTERPRISES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2008
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 MAPLE VALLEY DR
FARMINGTON MO
63640-1976
US

IV. Provider business mailing address

608 MAPLE VALLEY DR
FARMINGTON MO
63640-1976
US

V. Phone/Fax

Practice location:
  • Phone: 573-756-3400
  • Fax: 573-756-0800
Mailing address:
  • Phone: 573-756-3400
  • Fax: 573-756-0800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberR4G90
License Number StateMO

VIII. Authorized Official

Name: DR. STEPHEN W ORR
Title or Position: PHYSICIAN
Credential: D.C.
Phone: 573-756-3400