Provider Demographics
NPI:1033624457
Name:EASTSIDE DME SUPPLY
Entity Type:Organization
Organization Name:EASTSIDE DME SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUCHLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKEIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:216-751-8988
Mailing Address - Street 1:2775 S MORELAND BLVD FL 3
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-2397
Mailing Address - Country:US
Mailing Address - Phone:216-751-8988
Mailing Address - Fax:216-751-8990
Practice Address - Street 1:2775 S MORELAND BLVD FL 3
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-2397
Practice Address - Country:US
Practice Address - Phone:216-751-8988
Practice Address - Fax:216-751-8990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-07
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies