MEDICARE: O'BRIEN TECHNOLOGIES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1730330887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	O'BRIEN TECHNOLOGIES, INC.

Provider Business Mailing Address
First Line	:	45589 SHEPARD DR
Second Line	:	SUITE 101
City	:	STERLING
State	:	VA
Zip	:	20164-4409
Country	:	US
Telephone Number	:	703-430-3405
Fax Number	:

Provider Business Practice Location Address
First Line	:	45589 SHEPARD DR
Second Line	:
City	:	STERLING
State	:	VA
Zip	:	20164-4409
Country	:	US
Telephone Number	:	703-430-3405
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PAUL MANGUS
Credential	:
Telephone Number	:	301-529-0208

Provider Enumeration Date	:	10/07/2008
Last Update Date	:	03/29/2010

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