Provider Demographics
NPI:1336114123
Name:ORCHARD HEALTHCARE MANAGEMENT , INC
Entity Type:Organization
Organization Name:ORCHARD HEALTHCARE MANAGEMENT , INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DASKAL
Authorized Official - Suffix:
Authorized Official - Credentials:LNA
Authorized Official - Phone:216-898-8440
Mailing Address - Street 1:12380 PLAZA DR
Mailing Address - Street 2:100
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44130-1043
Mailing Address - Country:US
Mailing Address - Phone:216-898-8440
Mailing Address - Fax:216-898-8450
Practice Address - Street 1:12380 PLAZA DR
Practice Address - Street 2:100
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44130-1043
Practice Address - Country:US
Practice Address - Phone:216-898-8440
Practice Address - Fax:216-898-8450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH776773332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03124OtherPARAMOUT ELITE
OH0005031422OtherAETNA
OH0806042Medicaid
OH=========006OtherMEDICAL MUTUAL
OH0406220001Medicare NSC