Provider Demographics
NPI:1467757377
Name:TEZMED LLC
Entity Type:Organization
Organization Name:TEZMED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:TESNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-738-3082
Mailing Address - Street 1:1733 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2032
Mailing Address - Country:US
Mailing Address - Phone:614-738-3082
Mailing Address - Fax:614-447-8734
Practice Address - Street 1:3763 N HIGH ST STE C
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3547
Practice Address - Country:US
Practice Address - Phone:614-447-8733
Practice Address - Fax:614-447-8734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-24
Last Update Date:2015-08-11
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
OH6843910001Medicare NSC