Provider Demographics
NPI:1619658713
Name:OPTIMED HEALTHCARE PARTNERS, PLLC
Entity Type:Organization
Organization Name:OPTIMED HEALTHCARE PARTNERS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:269-250-8018
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:269-250-8000
Mailing Address - Fax:269-250-8020
Practice Address - Street 1:4021 CASCADE RD SE STE 60
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-2177
Practice Address - Country:US
Practice Address - Phone:269-250-8000
Practice Address - Fax:269-250-8020
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPTIMED HEALTHCARE PARTNERS, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty