Provider Demographics
NPI:1619129517
Name:EASTERN MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:EASTERN MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:P
Authorized Official - Last Name:LOGERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-327-3210
Mailing Address - Street 1:230 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:44615-1346
Mailing Address - Country:US
Mailing Address - Phone:330-627-2373
Mailing Address - Fax:330-627-3704
Practice Address - Street 1:230 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:44615-1346
Practice Address - Country:US
Practice Address - Phone:330-627-2373
Practice Address - Fax:330-627-3704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
OH332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2002193Medicaid
OH2002193Medicaid