Provider Demographics
NPI:1912364308
Name:DASCO-WAYNE NETWORK HOME MEDICAL EQIUPMENT, LLC
Entity Type:Organization
Organization Name:DASCO-WAYNE NETWORK HOME MEDICAL EQIUPMENT, LLC
Other - Org Name:DASCO HOME MEDICAL EQIUPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:MAZUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-901-2226
Mailing Address - Street 1:375 N WEST ST
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-1400
Mailing Address - Country:US
Mailing Address - Phone:614-901-2226
Mailing Address - Fax:614-901-2228
Practice Address - Street 1:527 PORTAGE RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-2027
Practice Address - Country:US
Practice Address - Phone:234-206-4508
Practice Address - Fax:234-466-4405
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DASCO HOME MEDICAL EQUIPMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-15
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0311129Medicaid