Provider Demographics
NPI:1366809741
Name:OAK RIDGE PASS, INC.
Entity type:Organization
Organization Name:OAK RIDGE PASS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-316-3000
Mailing Address - Street 1:913 N MARKET ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-3019
Mailing Address - Country:US
Mailing Address - Phone:302-316-3000
Mailing Address - Fax:302-316-3300
Practice Address - Street 1:913 N MARKET ST
Practice Address - Street 2:SUITE 200
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-3019
Practice Address - Country:US
Practice Address - Phone:302-316-3000
Practice Address - Fax:302-316-3300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-15
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies