Provider Demographics
NPI:1508465865
Name:OPTIMED HEALTH PARTNERS INC
Entity Type:Organization
Organization Name:OPTIMED HEALTH PARTNERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TED
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFFERTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-250-8000
Mailing Address - Street 1:6480 TECHNOLOGY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-8126
Mailing Address - Country:US
Mailing Address - Phone:269-250-8009
Mailing Address - Fax:
Practice Address - Street 1:1111 LUCERNE TER
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1016
Practice Address - Country:US
Practice Address - Phone:269-250-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPTIMED HEALTH PARTNERS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No251F00000XAgenciesHome Infusion