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General NPI Number Information
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NPI Number | 1548482128
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Entity Type | Organization
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Legal Business Name | OPTIMUS LLC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 8517 NORTH DIXIE DRIVE SUITE 300
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City | DAYTON
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State | OH
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Zip | 45414
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Country | US
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Telephone | 937-454-1900
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Fax | 937-454-1909
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Provider Business Mailing Address
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Address Line | 8517 NORTH DIXIE DRIVE SUITE 300
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City | DAYTON
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State | OH
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Zip | 45414
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Country | US
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Telephone | 937-454-1900
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Fax | 937-454-1909
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Authorized Official
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Title or Position | OWNER
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Name | JOHN BRANDT
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Credential | CPO
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Telephone | 937-454-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | LPO.11
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License Number State | OH
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