Provider Demographics
NPI:1376608950
Name:UTI MEDICAL INC
Entity Type:Organization
Organization Name:UTI MEDICAL INC
Other - Org Name:UTI MEDICAL LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:DYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-786-7884
Mailing Address - Street 1:1376 N PORTAGE PATH
Mailing Address - Street 2:SUITE F
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-5851
Mailing Address - Country:US
Mailing Address - Phone:877-786-7884
Mailing Address - Fax:330-836-5452
Practice Address - Street 1:1376 N PORTAGE PATH
Practice Address - Street 2:SUITE F
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-5851
Practice Address - Country:US
Practice Address - Phone:877-786-7884
Practice Address - Fax:330-836-5452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2348990Medicaid
OH2348990Medicaid