Provider Demographics
NPI:1508143520
Name:MATTSHOW INC.
Entity Type:Organization
Organization Name:MATTSHOW INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:F
Authorized Official - Last Name:TERRIACO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-786-1919
Mailing Address - Street 1:22939 BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44146-6068
Mailing Address - Country:US
Mailing Address - Phone:440-786-1919
Mailing Address - Fax:440-786-1104
Practice Address - Street 1:22939 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-6068
Practice Address - Country:US
Practice Address - Phone:440-786-1919
Practice Address - Fax:440-786-1104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies