Provider Demographics
NPI:1649484304
Name:BROADFIELD SERVICES
Entity type:Organization
Organization Name:BROADFIELD SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:JURIS
Authorized Official - Last Name:BARBINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-466-2522
Mailing Address - Street 1:7927 MIDDLE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:OH
Mailing Address - Zip Code:44057-3023
Mailing Address - Country:US
Mailing Address - Phone:440-466-2522
Mailing Address - Fax:440-466-7287
Practice Address - Street 1:7927 MIDDLE RIDGE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:OH
Practice Address - Zip Code:44057-3023
Practice Address - Country:US
Practice Address - Phone:440-466-2522
Practice Address - Fax:440-466-7287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0204175Medicaid