Provider Demographics
NPI:1972810463
Name:D&R HOME MEDICAL SUPPLY, LLC
Entity Type:Organization
Organization Name:D&R HOME MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:GATTUSO
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:330-477-4816
Mailing Address - Street 1:3029 WHIPPLE AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-3026
Mailing Address - Country:US
Mailing Address - Phone:330-477-4816
Mailing Address - Fax:330-477-3345
Practice Address - Street 1:3029 WHIPPLE AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-3026
Practice Address - Country:US
Practice Address - Phone:330-477-4816
Practice Address - Fax:330-477-3345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332H00000XSuppliersEyewear Supplier
No333300000XSuppliersEmergency Response System Companies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7604720OtherMEDICAID WAIVER PROVIDER