Provider Demographics
NPI:1801371232
Name:OPTIMAL HEALTH CARE INC
Entity Type:Organization
Organization Name:OPTIMAL HEALTH CARE INC
Other - Org Name:OHCINC - DME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:MINANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-790-4962
Mailing Address - Street 1:11377 ROBINWOOD DR STE 101
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-6713
Mailing Address - Country:US
Mailing Address - Phone:301-790-4962
Mailing Address - Fax:301-790-4951
Practice Address - Street 1:11377 ROBINWOOD DR STE 101
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6713
Practice Address - Country:US
Practice Address - Phone:301-790-4962
Practice Address - Fax:301-790-4951
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPTIMAL HEALTH CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-02
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD782606101Medicaid