Provider Demographics
NPI:1346570520
Name:EASTERN MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:EASTERN MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:LOGERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-480-9999
Mailing Address - Street 1:PO BOX 87
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44501-0087
Mailing Address - Country:US
Mailing Address - Phone:330-480-9999
Mailing Address - Fax:330-480-9906
Practice Address - Street 1:230 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:44615-1346
Practice Address - Country:US
Practice Address - Phone:330-627-2373
Practice Address - Fax:330-627-3704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH11357332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2002193Medicaid