Organization Name: | OPTIGEN INCORPORATED |
NPI Number: | 1578592309 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRIAN NANNIE (AUTHORIZED OFFICIAL) |
Mailing Address: | 1351 13th Ave S Ste 100 Jacksonville Beach |
State: | FL US |
Postal Code: | 322503234 |
Phone Number: | 9042491046 |
Fax Number: | 8773390180 |
NPI Enumeration Date: | 07/02/2006 |
NPI Last Update Date: | 12/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 2141 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |