Provider Demographics
NPI:1710177175
Name:REMCO MEDICAL, INC.
Entity Type:Organization
Organization Name:REMCO MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:R
Authorized Official - Last Name:BLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-744-4600
Mailing Address - Street 1:692 THEODORE ST STE A
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-2475
Mailing Address - Country:US
Mailing Address - Phone:815-744-4600
Mailing Address - Fax:815-744-4656
Practice Address - Street 1:692 THEODORE ST STE A
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-2475
Practice Address - Country:US
Practice Address - Phone:815-744-4600
Practice Address - Fax:815-744-4656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9970392OtherBLUE CROSS BLUE SHIELD
IL=========-002Medicaid
IL9970392OtherBLUE CROSS BLUE SHIELD