Provider Demographics
NPI:1619208477
Name:INNOVATIVE MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:INNOVATIVE MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:PULVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-544-7362
Mailing Address - Street 1:29001 CEDAR RD
Mailing Address - Street 2:SUITE 326
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-4062
Mailing Address - Country:US
Mailing Address - Phone:440-646-1286
Mailing Address - Fax:440-461-3585
Practice Address - Street 1:29001 CEDAR RD
Practice Address - Street 2:SUITE 326
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-4062
Practice Address - Country:US
Practice Address - Phone:440-646-1286
Practice Address - Fax:440-461-3585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH18901654332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies