Provider Demographics
NPI:1164481586
Name:OPIS MEDICAL SUPPLY, LLC
Entity type:Organization
Organization Name:OPIS MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:G
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-558-6561
Mailing Address - Street 1:10150 HIGHLAND MANOR DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-9713
Mailing Address - Country:US
Mailing Address - Phone:813-558-6620
Mailing Address - Fax:
Practice Address - Street 1:10150 HIGHLAND MANOR DR
Practice Address - Street 2:SUITE 300
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-9713
Practice Address - Country:US
Practice Address - Phone:813-558-6620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5538480001Medicare NSC
5538480001Medicare ID - Type Unspecified