Provider Demographics
NPI:1376545657
Name:REMEDI SENIORCARE OF OHIO LLC
Entity Type:Organization
Organization Name:REMEDI SENIORCARE OF OHIO LLC
Other - Org Name:REMEDI SENIORCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP STRATEGIC SOURCING
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRONFEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-927-8400
Mailing Address - Street 1:962 S DORSET RD
Mailing Address - Street 2:ATTENTION FINANCE
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-4705
Mailing Address - Country:US
Mailing Address - Phone:800-232-4239
Mailing Address - Fax:800-982-9148
Practice Address - Street 1:962 S DORSET RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-4705
Practice Address - Country:US
Practice Address - Phone:800-232-4239
Practice Address - Fax:800-982-9148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
MI5301006899333600000X
IN64000127A333600000X
OH021862350 033336L0003X
KYOH12953336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1376545657Medicaid
3637088OtherNCPDP NUMBER
OH2853863Medicaid
IN200918730AMedicaid
KY7100052840Medicaid
OH2853863Medicaid
KY7100052840Medicaid