Provider Demographics
NPI:1346784758
Name:ORRMD, INC.
Entity Type:Organization
Organization Name:ORRMD, INC.
Other - Org Name:MUSKINGUM PEDIATRICS AND URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OTHELLO
Authorized Official - Middle Name:R
Authorized Official - Last Name:REPUYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-454-7119
Mailing Address - Street 1:3814 JAMES CT
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-0965
Mailing Address - Country:US
Mailing Address - Phone:740-454-7119
Mailing Address - Fax:740-455-5155
Practice Address - Street 1:3814 JAMES CT
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-0965
Practice Address - Country:US
Practice Address - Phone:740-454-7119
Practice Address - Fax:740-455-5155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-041605261QP2300X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0347986Medicaid