| Organization Name: | ORTHO PRO MEDICAL SUPPLY INC |
| NPI Number: | 1245663160 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | OREST POROCH (SECRETARY/VICEPRESIDENT) |
| Mailing Address: | 401 E Prospect Ave Suite 112 Mt Prospect |
| State: | IL US |
| Postal Code: | 600563366 |
| Phone Number: | 7738185369 |
| Fax Number: | |
| NPI Enumeration Date: | 08/14/2013 |
| NPI Last Update Date: | 10/29/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |