Provider Demographics
NPI:1578515714
Name:VAN HARLINGEN INC
Entity Type:Organization
Organization Name:VAN HARLINGEN INC
Other - Org Name:SHAW & OTT MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARY
Authorized Official - Middle Name:W
Authorized Official - Last Name:VAN HARLINGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-524-4388
Mailing Address - Street 1:270 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-1200
Mailing Address - Country:US
Mailing Address - Phone:419-524-4388
Mailing Address - Fax:419-525-2354
Practice Address - Street 1:120 HARDING WAY E
Practice Address - Street 2:SUITE 101
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-1927
Practice Address - Country:US
Practice Address - Phone:419-462-3070
Practice Address - Fax:419-462-3079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0399313Medicaid
OH0173570003Medicare ID - Type Unspecified