Provider Demographics
NPI:1780926386
Name:OPTIMUS LLC
Entity type:Organization
Organization Name:OPTIMUS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDT
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:937-454-1900
Mailing Address - Street 1:975 BETHEL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1905
Mailing Address - Country:US
Mailing Address - Phone:614-263-5462
Mailing Address - Fax:614-263-6770
Practice Address - Street 1:975 BETHEL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214
Practice Address - Country:US
Practice Address - Phone:614-263-5462
Practice Address - Fax:614-263-6770
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPTIMUS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-21
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPO.11335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier