Provider Demographics
NPI:1518162155
Name:DRAYER MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:DRAYER MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARTON
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:DRAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-607-6858
Mailing Address - Street 1:2228-B SAGAMORE PKWY S
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-5112
Mailing Address - Country:US
Mailing Address - Phone:765-607-6858
Mailing Address - Fax:765-807-0090
Practice Address - Street 1:2228-B SAGAMORE PKWY S
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-5112
Practice Address - Country:US
Practice Address - Phone:765-607-6858
Practice Address - Fax:765-807-0090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200877980AMedicaid
IN5986830001Medicare NSC