Provider Demographics
NPI:1740352913
Name:OPMC, LLC.
Entity type:Organization
Organization Name:OPMC, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:MANFREDI
Authorized Official - Suffix:SR
Authorized Official - Credentials:CPO, LPO
Authorized Official - Phone:732-222-7033
Mailing Address - Street 1:788 SHREWSBURY AVE
Mailing Address - Street 2:BLDG. 1A, SUITE 109
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3080
Mailing Address - Country:US
Mailing Address - Phone:732-222-7033
Mailing Address - Fax:732-222-7066
Practice Address - Street 1:788 SHREWSBURY AVE
Practice Address - Street 2:BLDG. 1A, SUITE 109
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-3080
Practice Address - Country:US
Practice Address - Phone:732-222-7033
Practice Address - Fax:732-222-7066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ45PO00000200335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier