Provider Demographics
NPI:1952666927
Name:SEASHELL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:SEASHELL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-304-6695
Mailing Address - Street 1:4186 MAGGIE MARIE BLVD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-6955
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:320-514-0186
Practice Address - Street 1:4186 MAGGIE MARIE BLVD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-6955
Practice Address - Country:US
Practice Address - Phone:330-304-6695
Practice Address - Fax:320-514-0186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-05
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies