Provider Demographics
NPI:1164502308
Name:PREMIER MEDICAL EQUIPMENT & SUPPLIES, INC
Entity Type:Organization
Organization Name:PREMIER MEDICAL EQUIPMENT & SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARSHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-529-0100
Mailing Address - Street 1:1352 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-1828
Mailing Address - Country:US
Mailing Address - Phone:419-529-0100
Mailing Address - Fax:567-241-0026
Practice Address - Street 1:1352 W 4TH ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-1828
Practice Address - Country:US
Practice Address - Phone:419-529-0100
Practice Address - Fax:567-241-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02-1624900332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
22000000360916OtherINTEGRATED HEALTH PLAN
OH2550350Medicaid
5259190001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER