Provider Demographics
NPI:1346983764
Name:PATRICK R MCCREARY INC.
Entity Type:Organization
Organization Name:PATRICK R MCCREARY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCCREARY
Authorized Official - Suffix:I
Authorized Official - Credentials:GRADUATE SWM COLLEGE
Authorized Official - Phone:937-674-1020
Mailing Address - Street 1:1204 HOLLOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-1828
Mailing Address - Country:US
Mailing Address - Phone:937-674-1020
Mailing Address - Fax:
Practice Address - Street 1:1204 HOLLOWBROOK DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-1828
Practice Address - Country:US
Practice Address - Phone:937-674-1020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-14
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRN220411OtherDRIVER LICENSE