OPTIMUSMED LLC NPI 1124282108

NPI Information

  • NPI: 1124282108
  • Provider Name: OPTIMUSMED, LLC
  • Classification: Prosthetic/Orthotic Supplier - 335E00000X
  • Entity Type: Organization
  • Address: 1305 LAKES PKWY
    SUITE 109
    LAWRENCEVILLE, GA
    ZIP 30043
  • Phone: (770) 822-6787

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NPI Details

OPTIMUSMED, LLC is a prosthetic orthotic supplier in Lawrenceville, GA. The provider is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. OPTIMUSMED, LLC NPI is 1124282108. The provider is registered as an organization entity type.

The provider's business location address is:

1305 LAKES PKWY
SUITE 109
LAWRENCEVILLE, GA
ZIP 30043-886
Phone: (770) 822-6787
Fax: (800) 454-9615

The provider's authorized official is Dave Mowry .
The authorized official title is Ceo and has the following contact phone number (760) 795-5440.

The enumeration date for this NPI number is 7/18/2008 and was last updated on 3/6/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2335E00000XProsthetic/Orthotic Supplier000047GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1416145694BMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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