Provider Demographics
NPI:1811990302
Name:AERATECH MEDICAL INC
Entity type:Organization
Organization Name:AERATECH MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:L
Authorized Official - Last Name:NEELY
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:330-722-1711
Mailing Address - Street 1:4569 CRYSTAL PKWY
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-8022
Mailing Address - Country:US
Mailing Address - Phone:330-722-1711
Mailing Address - Fax:330-470-2664
Practice Address - Street 1:4569 CRYSTAL PKWY
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-8022
Practice Address - Country:US
Practice Address - Phone:330-722-1711
Practice Address - Fax:330-470-2664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2125891Medicaid
341889850002OtherMEDICAL MUTUAL OF OHIO #
OH1266310002Medicare NSC