Provider Demographics
NPI:1205823531
Name:DURAMED EQUIPMENT, LLC
Entity Type:Organization
Organization Name:DURAMED EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EARL
Authorized Official - Middle Name:P
Authorized Official - Last Name:MUNTEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-487-1075
Mailing Address - Street 1:207 PORTAGE TRAIL EXT W
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-1297
Mailing Address - Country:US
Mailing Address - Phone:330-487-1075
Mailing Address - Fax:773-439-8958
Practice Address - Street 1:207 PORTAGE TRAIL EXT W
Practice Address - Street 2:SUITE 100
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-1297
Practice Address - Country:US
Practice Address - Phone:330-487-1075
Practice Address - Fax:773-439-8958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1535579332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7704584Medicaid
OH2716798Medicaid
SCDM1200Medicaid
SCDM1200Medicaid