Provider Demographics
NPI:1396836391
Name:ORION MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:ORION MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BUCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-857-3941
Mailing Address - Street 1:10580 N MCCARRAN BLVD
Mailing Address - Street 2:115-541
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-2059
Mailing Address - Country:US
Mailing Address - Phone:714-649-9284
Mailing Address - Fax:714-594-4038
Practice Address - Street 1:10580 N MCCARRAN BLVD
Practice Address - Street 2:115-541
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-2059
Practice Address - Country:US
Practice Address - Phone:714-649-9284
Practice Address - Fax:714-594-4038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV61976332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies