MEDICARE: AMISH OAK FURNITURE COMPANY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1295910669
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMISH OAK FURNITURE COMPANY

Provider Business Mailing Address
First Line	:	268 W MAIN ST
Second Line	:
City	:	LOUDONVILLE
State	:	OH
Zip	:	44842-1134
Country	:	US
Telephone Number	:	419-994-5595
Fax Number	:	419-994-3860

Provider Business Practice Location Address
First Line	:	268 W MAIN ST
Second Line	:
City	:	LOUDONVILLE
State	:	OH
Zip	:	44842-1134
Country	:	US
Telephone Number	:	419-994-5595
Fax Number	:	419-994-3860

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	CHRIS D TUTTLE
Credential	:
Telephone Number	:	419-994-5595

Provider Enumeration Date	:	01/04/2008
Last Update Date	:	01/04/2008

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Directions to “AMISH OAK FURNITURE COMPANY ” Practice Location

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