Provider Demographics
NPI:1487820676
Name:HORVATH MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:HORVATH MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROSTHETIST OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FERENCZ
Authorized Official - Middle Name:F
Authorized Official - Last Name:HORVATH
Authorized Official - Suffix:
Authorized Official - Credentials:LP
Authorized Official - Phone:440-357-2371
Mailing Address - Street 1:9930 JOHNNYCAKE RIDGE RD
Mailing Address - Street 2:UNIT 1C
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-6771
Mailing Address - Country:US
Mailing Address - Phone:440-357-2371
Mailing Address - Fax:440-357-2381
Practice Address - Street 1:9930 JOHNNYCAKE RIDGE RD
Practice Address - Street 2:UNIT 1C
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-6771
Practice Address - Country:US
Practice Address - Phone:440-357-2371
Practice Address - Fax:440-357-2381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLP0051224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0223485Medicaid
OH0223485Medicaid