Provider Demographics
NPI:1447205208
Name:DILLER MEDICAL EQUIPMENT INC
Entity Type:Organization
Organization Name:DILLER MEDICAL EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:DILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-358-2761
Mailing Address - Street 1:902 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:OH
Mailing Address - Zip Code:45817-9710
Mailing Address - Country:US
Mailing Address - Phone:419-358-2761
Mailing Address - Fax:419-358-7777
Practice Address - Street 1:902 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:OH
Practice Address - Zip Code:45817-9710
Practice Address - Country:US
Practice Address - Phone:419-358-2761
Practice Address - Fax:419-358-7777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0446959Medicaid
OH0446959Medicaid