Provider Demographics
NPI:1821280355
Name:ORTHOMED, LLC
Entity Type:Organization
Organization Name:ORTHOMED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:MELISSA
Authorized Official - Last Name:SMEDLEY-GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-869-0000
Mailing Address - Street 1:901 S GREENWOOD AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-5835
Mailing Address - Country:US
Mailing Address - Phone:323-869-0000
Mailing Address - Fax:323-869-8880
Practice Address - Street 1:901 S GREENWOOD AVE
Practice Address - Street 2:SUITE C
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-5835
Practice Address - Country:US
Practice Address - Phone:323-869-0000
Practice Address - Fax:323-869-8880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies