Healthcare Provider Details
I. General information
NPI: 1790846434
Provider Name (Legal Business Name): ORL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/13/2006
Last Update Date: 10/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
915 WEST MICHIGAN YAGER BLDG, SUITE 301
SIDNEY OH
45365-2401
US
IV. Provider business mailing address
915 WEST MICHIGAN YAGER BLDG, SUITE 301
SIDNEY OH
45365-2401
US
V. Phone/Fax
- Phone: 937-498-2361
- Fax: 937-498-7451
- Phone: 937-498-2361
- Fax: 937-498-7451
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DARSHAN
K
VYAS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 937-498-2361