1689615643 NPI number — VISITING NURSE EQUIPMENT AND SUPPLIES INC

Table of content: (NPI 1689615643)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689615643 NPI number — VISITING NURSE EQUIPMENT AND SUPPLIES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VISITING NURSE EQUIPMENT AND SUPPLIES INC
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:
VISITING NURSE EQUIPMENT AND SUPPLIES
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:
1689615643
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/20/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 HOME CARE PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AKRON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44320-3901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-745-1601
Provider Business Mailing Address Fax Number:
330-848-6211

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
160 OPPORTUNITY PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AKRON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44307-2211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-434-1114
Provider Business Practice Location Address Fax Number:
330-434-6550
Provider Enumeration Date:
06/09/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BAUMAN
Authorized Official First Name:
JERRY
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
330-848-6165

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  77164938 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0565651 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2173188 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".