MEDICARE: BES OF OHIO, LLC DBA MEDGROUP

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

General Provider Information

NPI Number	:	1447490461
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BES OF OHIO, LLC DBA MEDGROUP

Provider Business Mailing Address
First Line	:	13916 CEDAR RD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-3204
Country	:	US
Telephone Number	:	216-381-9000
Fax Number	:	216-381-2151

Provider Business Practice Location Address
First Line	:	13916 CEDAR RD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-3204
Country	:	US
Telephone Number	:	216-381-9000
Fax Number	:	216-381-2151

Authorized Official
Title or Position	:	PRESIDENT/MD
Name	:	DEAN ERICKSON
Credential	:	MD
Telephone Number	:	216-381-9000

Provider Enumeration Date	:	03/03/2009
Last Update Date	:	09/03/2009

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