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General NPI Number Information
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NPI Number | 1720536139
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Entity Type | Organization
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Legal Business Name | ORTHOSUPPLY, LLC
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 09/16/2016
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Provider Practice Location Address
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Address Line | 10 MAIN STREET UNIT 177
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City | WOODBRIDGE
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State | NJ
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Zip | 07095
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Country | US
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Telephone | 410-916-8758
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Fax | 201-503-8167
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Provider Business Mailing Address
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Address Line | 10 MAIN ST UNIT 177
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-3300
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Country | US
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Telephone | 410-916-8758
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Fax | 201-503-8167
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DANIEL ROSS
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Credential |
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Telephone | 410-916-8758
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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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