Provider Demographics
NPI:1932385895
Name:DURAMED EQUIPMENT, LLC
Entity Type:Organization
Organization Name:DURAMED EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EARL
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNTEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-487-1075
Mailing Address - Street 1:207 PORTAGE TRAIL EXT W
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-1297
Mailing Address - Country:US
Mailing Address - Phone:330-487-1075
Mailing Address - Fax:330-487-1085
Practice Address - Street 1:1721 EBENEZER RD
Practice Address - Street 2:SUITE 290
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-4103
Practice Address - Country:US
Practice Address - Phone:803-325-8110
Practice Address - Fax:773-439-8958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC046311944332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7704584Medicaid
OH2716798Medicaid
SCDM1200Medicaid
5440080001Medicare NSC