Provider Demographics
NPI:1568534543
Name:R.K. WOOD PRODUCTS
Entity Type:Organization
Organization Name:R.K. WOOD PRODUCTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:DEMETRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-755-7090
Mailing Address - Street 1:5354 NEW CASTLE RD
Mailing Address - Street 2:
Mailing Address - City:LOWELLVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44436-9532
Mailing Address - Country:US
Mailing Address - Phone:330-755-7090
Mailing Address - Fax:330-755-7092
Practice Address - Street 1:2773 E MIDLOTHIAN BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:STRUTHERS
Practice Address - State:OH
Practice Address - Zip Code:44471-1005
Practice Address - Country:US
Practice Address - Phone:330-755-7090
Practice Address - Fax:330-755-7092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001681310Medicaid
OH0842888Medicaid
OH2059721Medicaid
OH0950960001Medicare NSC