Provider Demographics
NPI:1386893741
Name:ORBIT MEDICAL OF PHILADELPHIA INC
Entity type:Organization
Organization Name:ORBIT MEDICAL OF PHILADELPHIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLUP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-713-2020
Mailing Address - Street 1:716 E 4500 S
Mailing Address - Street 2:SUITE 260S
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-3080
Mailing Address - Country:US
Mailing Address - Phone:801-713-2020
Mailing Address - Fax:
Practice Address - Street 1:104 HENDERSON DR
Practice Address - Street 2:
Practice Address - City:SHARON HILL
Practice Address - State:PA
Practice Address - Zip Code:19079-1033
Practice Address - Country:US
Practice Address - Phone:610-586-0550
Practice Address - Fax:610-586-0559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-10
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000007251332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6171150001Medicare NSC