Provider Demographics
NPI:1265454144
Name:OPTI BILL, INC.
Entity Type:Organization
Organization Name:OPTI BILL, INC.
Other - Org Name:OPTIMUM MEDICAL SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:COLERIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-704-1770
Mailing Address - Street 1:24950 COUNTRY CLUB BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-5342
Mailing Address - Country:US
Mailing Address - Phone:440-359-8704
Mailing Address - Fax:440-359-8744
Practice Address - Street 1:24950 COUNTRY CLUB BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-5342
Practice Address - Country:US
Practice Address - Phone:440-359-8704
Practice Address - Fax:440-359-8744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0827207Medicaid
OH0603980001Medicare NSC