Provider Demographics
NPI:1346302312
Name:ADAPTIVE MEDICAL CONCEPTS, INC.
Entity Type:Organization
Organization Name:ADAPTIVE MEDICAL CONCEPTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:YOUNGPETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-773-8270
Mailing Address - Street 1:1378 BELLEFONTAINE AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-3110
Mailing Address - Country:US
Mailing Address - Phone:419-224-5410
Mailing Address - Fax:419-222-6566
Practice Address - Street 1:216 KENTUCKY ST.
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:OH
Practice Address - Zip Code:45854
Practice Address - Country:US
Practice Address - Phone:419-773-8270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0954301Medicaid
OH0954301Medicaid