Provider Demographics
NPI:1255330825
Name:EDWARDS HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:EDWARDS HEALTH CARE SERVICES, INC.
Other - Org Name:DIRECT HEALTHCARE SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEE
Authorized Official - Middle Name:E
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:330-342-9555
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-0309
Mailing Address - Country:US
Mailing Address - Phone:330-342-9555
Mailing Address - Fax:330-342-9559
Practice Address - Street 1:5640 HUDSON INDUSTRIAL PKWY
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-5011
Practice Address - Country:US
Practice Address - Phone:330-342-9555
Practice Address - Fax:330-342-9559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH77182076332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2054093Medicaid
OH2054093Medicaid