1477629079 NPI number — HILLMED SURGICAL CORPORATION

Table of content: (NPI 1477629079)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477629079 NPI number — HILLMED SURGICAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HILLMED SURGICAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HILLMED HOME MEDICAL SYSTEMS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477629079
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12800 SHAKER BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44120-2033
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-619-4900
Provider Business Mailing Address Fax Number:
216-752-3991

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12800 SHAKER BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44120-2033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-619-4900
Provider Business Practice Location Address Fax Number:
216-752-3991
Provider Enumeration Date:
11/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCILWAINE
Authorized Official First Name:
ANDREA
Authorized Official Middle Name:
LISA
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
216-619-4900

Provider Taxonomy Codes

  • Taxonomy code: 332BP3500X , with the licence number:  HMER22066 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X , with the licence number: HMER22066 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 333600000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0596305 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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