=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578730545
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OROSI MEDICAL SUPPLY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/09/2008
-----------------------------------------------------
Last Update Date | 11/18/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12579 AVENUE 416
-----------------------------------------------------
City | OROSI
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93647-2056
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-528-9181
-----------------------------------------------------
Fax | 559-528-9181
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12579 AVENUE 416
-----------------------------------------------------
City | OROSI
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93647-2056
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-528-9181
-----------------------------------------------------
Fax | 559-528-9181
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESEDENT
-----------------------------------------------------
Name | EDUARDA BLANEY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 559-528-9181
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | KHO 101-077577
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------