Provider Demographics
NPI:1629437058
Name:ORBIT MEDICALS SERVICES LLC
Entity Type:Organization
Organization Name:ORBIT MEDICALS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AL JAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-918-7259
Mailing Address - Street 1:1111 S ORCHARD ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-1966
Mailing Address - Country:US
Mailing Address - Phone:208-918-7259
Mailing Address - Fax:
Practice Address - Street 1:1111 S ORCHARD ST
Practice Address - Street 2:SUITE 209
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-1966
Practice Address - Country:US
Practice Address - Phone:208-918-7259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-13
Last Update Date:2016-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDW159670253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care