Provider Demographics
NPI:1992844633
Name:INDEPENDENT MEDICAL SUPPLY
Entity Type:Organization
Organization Name:INDEPENDENT MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCANLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-748-4012
Mailing Address - Street 1:9240 ROOT RD
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-4366
Mailing Address - Country:US
Mailing Address - Phone:440-748-4012
Mailing Address - Fax:440-748-2453
Practice Address - Street 1:9240 ROOT RD
Practice Address - Street 2:
Practice Address - City:NORTH RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-4366
Practice Address - Country:US
Practice Address - Phone:440-748-4012
Practice Address - Fax:440-748-2453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1463676332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies