Provider Demographics
NPI:1316231533
Name:NORTHCOAST ORTHOPEDIC SALES, LLC
Entity Type:Organization
Organization Name:NORTHCOAST ORTHOPEDIC SALES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:F
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-650-2022
Mailing Address - Street 1:4301 DARROW RD STE 3250
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-7603
Mailing Address - Country:US
Mailing Address - Phone:330-650-2022
Mailing Address - Fax:877-496-2071
Practice Address - Street 1:4301 DARROW RD STE 3250
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-7603
Practice Address - Country:US
Practice Address - Phone:330-650-2022
Practice Address - Fax:877-496-2071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-06
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies