Provider Demographics
NPI:1689859860
Name:FIDELITY MEDICAL PRODUCTS LLC
Entity Type:Organization
Organization Name:FIDELITY MEDICAL PRODUCTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:PAPLACZYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-459-3749
Mailing Address - Street 1:3366 RIVERSIDE DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-1734
Mailing Address - Country:US
Mailing Address - Phone:614-459-3749
Mailing Address - Fax:614-459-8749
Practice Address - Street 1:3366 RIVERSIDE DR
Practice Address - Street 2:SUITE 104
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-1734
Practice Address - Country:US
Practice Address - Phone:614-459-3749
Practice Address - Fax:614-459-8749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4674140003Medicare NSC