Provider Demographics
NPI:1235911025
Name:OMI MEDTECH LLC
Entity Type:Organization
Organization Name:OMI MEDTECH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICK
Authorized Official - Middle Name:
Authorized Official - Last Name:GAFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-356-9696
Mailing Address - Street 1:3400 SAINT JOHNS PKWY STE 1020
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-6769
Mailing Address - Country:US
Mailing Address - Phone:407-680-2196
Mailing Address - Fax:
Practice Address - Street 1:3400 SAINT JOHNS PKWY STE 1020
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-6769
Practice Address - Country:US
Practice Address - Phone:407-680-2196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies