Provider Demographics
NPI:1174637078
Name:CHV HOME MEDICAL EQUIPMENT COMPANY, LLC
Entity Type:Organization
Organization Name:CHV HOME MEDICAL EQUIPMENT COMPANY, LLC
Other - Org Name:VISITING NURSE SERVICE EQUIPMENT AND SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT AGHS VNSA
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-848-6203
Mailing Address - Street 1:1 HOME CARE PL
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-3901
Mailing Address - Country:US
Mailing Address - Phone:330-745-1601
Mailing Address - Fax:330-848-6216
Practice Address - Street 1:155 LINCOLN WAY W
Practice Address - Street 2:A-96 SUITE 1
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44647-6583
Practice Address - Country:US
Practice Address - Phone:330-837-6873
Practice Address - Fax:330-434-6550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH77190692332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5801920001Medicare PIN