Provider Demographics
NPI:1851487946
Name:OPTIMUM HEALTH MANAGEMENT CORPORATION
Entity Type:Organization
Organization Name:OPTIMUM HEALTH MANAGEMENT CORPORATION
Other - Org Name:OPTIMUM MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:LARRY
Authorized Official - Last Name:OZOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-924-9901
Mailing Address - Street 1:4024 LAWRENCEVILLE HWY NW STE 18
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-2805
Mailing Address - Country:US
Mailing Address - Phone:678-924-9901
Mailing Address - Fax:678-924-9788
Practice Address - Street 1:4024 LAWRENCEVILLE HWY NW STE 18
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-2805
Practice Address - Country:US
Practice Address - Phone:678-924-9901
Practice Address - Fax:678-924-9788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA4272290001Medicare ID - Type Unspecified