Provider Demographics
NPI:1861667008
Name:MVI HOMECARE
Entity Type:Organization
Organization Name:MVI HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMIOLI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:330-759-9487
Mailing Address - Street 1:4891 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1015
Mailing Address - Country:US
Mailing Address - Phone:330-759-9487
Mailing Address - Fax:330-759-9564
Practice Address - Street 1:4891 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1015
Practice Address - Country:US
Practice Address - Phone:330-759-9487
Practice Address - Fax:330-759-9564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2172410Medicaid