Provider Demographics
NPI:1083716484
Name:CHV HOME MEDICAL EQUIPMENT COMPANY, LLC
Entity Type:Organization
Organization Name:CHV HOME MEDICAL EQUIPMENT COMPANY, LLC
Other - Org Name:VISITING NURSE EQUIPMENT AND SUPPLIES INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-745-1601
Mailing Address - Street 1:160 OPPORTUNITY PARKWAY
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44307
Mailing Address - Country:US
Mailing Address - Phone:330-434-1114
Mailing Address - Fax:330-434-6550
Practice Address - Street 1:930 AMHERST RD NE
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-4568
Practice Address - Country:US
Practice Address - Phone:800-524-2362
Practice Address - Fax:330-434-6550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPENDING332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2173188Medicaid
OH2173188Medicaid