1629174560 NPI number — CARDINAL HOME MEDICAL INC.

Table of content: (NPI 1629174560)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629174560 NPI number — CARDINAL HOME MEDICAL INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARDINAL HOME MEDICAL 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:
Provider Other Organization Name Type Code:
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:
1629174560
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1387 MARLOWE AVE
Provider Second Line Business Mailing Address:
SUITE #6
Provider Business Mailing Address City Name:
LAKEWOOD
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44107-2676
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-226-1112
Provider Business Mailing Address Fax Number:
216-226-2409

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1387 MARLOWE AVE
Provider Second Line Business Practice Location Address:
SUITE #6
Provider Business Practice Location Address City Name:
LAKEWOOD
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44107-2676
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-226-1112
Provider Business Practice Location Address Fax Number:
216-226-2409
Provider Enumeration Date:
09/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BENNETT
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
SECRETARY/RESPIRATORY THERAPIST
Authorized Official Telephone Number:
216-226-1112

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X , with the licence number:  HMEP 33005 , 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: 0197844 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com