Provider Demographics
NPI:1699357251
Name:MP MEDICAL SUPPLY, LLC
Entity Type:Organization
Organization Name:MP MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SMALDONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-386-0762
Mailing Address - Street 1:757 ALPHA DR STE C
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2173
Mailing Address - Country:US
Mailing Address - Phone:216-386-0762
Mailing Address - Fax:
Practice Address - Street 1:757 ALPHA DR STE C
Practice Address - Street 2:
Practice Address - City:HIGHLAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-2173
Practice Address - Country:US
Practice Address - Phone:216-386-0762
Practice Address - Fax:216-250-8102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-23
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies