Provider Demographics
NPI:1013527795
Name:ORTHOPEDIC MEDICAL DEVICES, LLC
Entity Type:Organization
Organization Name:ORTHOPEDIC MEDICAL DEVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ZINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-980-9501
Mailing Address - Street 1:176 WABASSO TRL
Mailing Address - Street 2:
Mailing Address - City:MEDFORD LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-1417
Mailing Address - Country:US
Mailing Address - Phone:609-980-9501
Mailing Address - Fax:
Practice Address - Street 1:176 WABASSO TRL
Practice Address - Street 2:
Practice Address - City:MEDFORD LAKES
Practice Address - State:NJ
Practice Address - Zip Code:08055-1417
Practice Address - Country:US
Practice Address - Phone:609-980-9501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies