Provider Demographics
NPI:1790319663
Name:MARWAY L.A.S., INC.
Entity Type:Organization
Organization Name:MARWAY L.A.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRODNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-974-0869
Mailing Address - Street 1:8451 MENTOR AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-5839
Mailing Address - Country:US
Mailing Address - Phone:440-974-0869
Mailing Address - Fax:866-257-1675
Practice Address - Street 1:8451 MENTOR AVE STE 1
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-5839
Practice Address - Country:US
Practice Address - Phone:440-974-0869
Practice Address - Fax:866-257-1675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care