Provider Demographics
NPI:1295148195
Name:ADAPTIVE MEDICAL MARKETING, INC
Entity type:Organization
Organization Name:ADAPTIVE MEDICAL MARKETING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHANTELL
Authorized Official - Middle Name:T
Authorized Official - Last Name:SHREVES
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:419-224-5410
Mailing Address - Street 1:1378 BELLEFONTAINE AVE
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804
Mailing Address - Country:US
Mailing Address - Phone:419-224-5410
Mailing Address - Fax:419-222-6566
Practice Address - Street 1:1378 BELLEFONTAINE AVE
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804
Practice Address - Country:US
Practice Address - Phone:419-224-5410
Practice Address - Fax:419-222-6566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-09
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies