Provider Demographics
NPI: | 1598039216 |
---|---|
Name: | ELITE MEDICAL SUPPLIES OF OH, INC. |
Entity Type: | Organization |
Organization Name: | ELITE MEDICAL SUPPLIES OF OH, INC. |
Other - Org Name: | ELITE MEDICAL SUPPLIES |
Other - Org Type: | Other Name |
Authorized Official - Title/Position: | OWNER/PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RAKESH |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | KAPIL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 740-326-1108 |
Mailing Address - Street 1: | 206 S MAIN ST |
Mailing Address - Street 2: | |
Mailing Address - City: | MOUNT VERNON |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 43050-3304 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 740-326-1108 |
Mailing Address - Fax: | 740-326-1109 |
Practice Address - Street 1: | 206 S MAIN ST |
Practice Address - Street 2: | |
Practice Address - City: | MOUNT VERNON |
Practice Address - State: | OH |
Practice Address - Zip Code: | 43050-3304 |
Practice Address - Country: | US |
Practice Address - Phone: | 740-326-1108 |
Practice Address - Fax: | 740-326-1109 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | ELITE MEDICAL SUPPLIES |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2012-02-27 |
Last Update Date: | 2012-10-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |