MEDICARE: A J&B HERMAN ENTERPRISE, INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies	HME22028	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000002498007	OTHER	OH	ANTHEM BCBS
2	8700304	OTHER	OH	WAIVER-INDIVIDUAL OPTIONS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417077033
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A J&B HERMAN ENTERPRISE, INC.

Provider Business Mailing Address
First Line	:	25671 FORT MEIGS RD
Second Line	:
City	:	PERRYSBURG
State	:	OH
Zip	:	43551-1191
Country	:	US
Telephone Number	:	419-872-4775
Fax Number	:	419-872-4776

Provider Business Practice Location Address
First Line	:	1162 PARK AVE E
Second Line	:	STATE RT #430
City	:	MANSFIELD
State	:	OH
Zip	:	44905-2632
Country	:	US
Telephone Number	:	419-756-9799
Fax Number	:	419-756-7308

Authorized Official
Title or Position	:	PRESIDENT CEO
Name	:	BARBARA M HERMAN
Credential	:
Telephone Number	:	419-872-4775

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	08/22/2020

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