Provider Demographics
NPI:1689615643
Name:VISITING NURSE EQUIPMENT AND SUPPLIES INC
Entity Type:Organization
Organization Name:VISITING NURSE EQUIPMENT AND SUPPLIES INC
Other - Org Name:VISITING NURSE EQUIPMENT AND SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-848-6165
Mailing Address - Street 1:1 HOME CARE PL
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-3901
Mailing Address - Country:US
Mailing Address - Phone:330-745-1601
Mailing Address - Fax:330-848-6211
Practice Address - Street 1:160 OPPORTUNITY PKWY
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2211
Practice Address - Country:US
Practice Address - Phone:330-434-1114
Practice Address - Fax:330-434-6550
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VISITING NURSE SERVICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-09
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH77164938332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0565651Medicaid
OH2173188Medicaid
OH0268530001Medicare ID - Type UnspecifiedSUMMIT