Provider Demographics
NPI:1811386915
Name:REIDY MEDICAL SUPPLY, INC
Entity Type:Organization
Organization Name:REIDY MEDICAL SUPPLY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TED
Authorized Official - Middle Name:
Authorized Official - Last Name:STITZEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-686-4485
Mailing Address - Street 1:1397 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-1736
Mailing Address - Country:US
Mailing Address - Phone:330-686-4485
Mailing Address - Fax:888-809-2723
Practice Address - Street 1:1397 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-1736
Practice Address - Country:US
Practice Address - Phone:330-686-4485
Practice Address - Fax:888-809-2723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-13
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies