Provider Demographics
NPI:1790106052
Name:DAVID LOGERO DBA EASTERN MEDICAL
Entity Type:Organization
Organization Name:DAVID LOGERO DBA EASTERN MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LOGERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-233-0853
Mailing Address - Street 1:PO BOX 5264
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-0264
Mailing Address - Country:US
Mailing Address - Phone:814-233-0853
Mailing Address - Fax:
Practice Address - Street 1:930 ALBERT ST
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515
Practice Address - Country:US
Practice Address - Phone:800-327-3210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies