Provider Demographics
NPI:1477629079
Name:HILLMED SURGICAL CORPORATION
Entity Type:Organization
Organization Name:HILLMED SURGICAL CORPORATION
Other - Org Name:HILLMED HOME MEDICAL SYSTEMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:LISA
Authorized Official - Last Name:MCILWAINE
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:216-619-4900
Mailing Address - Street 1:12800 SHAKER BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-2033
Mailing Address - Country:US
Mailing Address - Phone:216-619-4900
Mailing Address - Fax:216-752-3991
Practice Address - Street 1:12800 SHAKER BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-2033
Practice Address - Country:US
Practice Address - Phone:216-619-4900
Practice Address - Fax:216-752-3991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHHMER22066332BP3500X, 332BX2000X
OH333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0596305Medicaid
OH0596305Medicaid