Provider Demographics
NPI:1558432294
Name:JOSEPH D CHASE
Entity Type:Organization
Organization Name:JOSEPH D CHASE
Other - Org Name:SOUTHWEST SURGICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHASE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-888-1283
Mailing Address - Street 1:6448 PEARL RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-2909
Mailing Address - Country:US
Mailing Address - Phone:440-888-1283
Mailing Address - Fax:440-888-1283
Practice Address - Street 1:6448 PEARL RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-2909
Practice Address - Country:US
Practice Address - Phone:440-888-1283
Practice Address - Fax:440-888-1283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0253740001Medicare NSC