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General NPI Number Information
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NPI Number | 1023596012
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Entity Type | Organization
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Legal Business Name | MEDICAL PRODUCTS GROUP, LLC
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Dates
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Enumeration Date | 08/01/2018
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Last Update Date | 06/27/2019
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Provider Practice Location Address
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Address Line | 641 PALMYRA RD
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City | DIXON
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State | IL
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Zip | 61021-9139
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Country | US
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Telephone | 815-284-9771
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 43842
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City | LOUISVILLE
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State | KY
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Zip | 40253-0842
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Country | US
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Telephone | 630-462-6770
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. OSAWARU OMORUYI
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Credential | MD
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Telephone | 630-462-6770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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