Provider Demographics
NPI:1346236635
Name:HUBER MEDICAL LLC
Entity Type:Organization
Organization Name:HUBER MEDICAL LLC
Other - Org Name:COMMUNITY HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:PITZULO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-629-9500
Mailing Address - Street 1:60 N CANFIELD NILES RD STE 500
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2338
Mailing Address - Country:US
Mailing Address - Phone:330-629-9500
Mailing Address - Fax:330-259-0326
Practice Address - Street 1:60 N CANFIELD NILES RD STE 500
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2338
Practice Address - Country:US
Practice Address - Phone:330-629-9500
Practice Address - Fax:330-259-0326
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUBER MEDICAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-22
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
3670432OtherOTHER ID NUMBER-COMMERCIAL NUMBER
OH2218353Medicaid
OH2218353Medicaid