Provider Demographics
NPI:1881627024
Name:ORBIT MEDICAL, INC.
Entity type:Organization
Organization Name:ORBIT MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLUP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-713-2020
Mailing Address - Street 1:716 E 4500 S
Mailing Address - Street 2:SUITE 260S
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-3080
Mailing Address - Country:US
Mailing Address - Phone:801-713-2020
Mailing Address - Fax:
Practice Address - Street 1:4500 EMPIRE WAY
Practice Address - Street 2:SUITE 2
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-9580
Practice Address - Country:US
Practice Address - Phone:517-322-4035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIU ME 0157893332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5300170002Medicare ID - Type Unspecified