Provider Demographics
NPI:1669098398
Name:OPTIMED HEALTH PARTNERS INC
Entity type:Organization
Organization Name:OPTIMED HEALTH PARTNERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TED
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFFERTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-250-8000
Mailing Address - Street 1:6480 TECHNOLOGY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-8126
Mailing Address - Country:US
Mailing Address - Phone:269-250-8009
Mailing Address - Fax:269-250-8020
Practice Address - Street 1:6480 TECHNOLOGY AVE STE A
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-8126
Practice Address - Country:US
Practice Address - Phone:269-250-8009
Practice Address - Fax:269-250-8020
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPTIMED HEALTH PARTNERS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy