MEDICARE: O'RYAN HEALTHCARE GROUP, 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750371787
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	O'RYAN HEALTHCARE GROUP, INC.

Provider Business Mailing Address
First Line	:	4600 SPRINGBORO PIKE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45439-1930
Country	:	US
Telephone Number	:	937-294-9355
Fax Number	:	937-294-7544

Provider Business Practice Location Address
First Line	:	4600 SPRINGBORO PIKE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45439-1930
Country	:	US
Telephone Number	:	937-294-9355
Fax Number	:	937-294-7544

Authorized Official
Title or Position	:	OWNER AND CEO
Name	:	MR. JERRY A. O'RYAN
Credential	:
Telephone Number	:	937-294-9355

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	08/22/2020

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