Healthcare Provider Details

I. General information

NPI: 1346248341
Provider Name (Legal Business Name): SEELEY MEDICAL OXYGEN CO OF ANDOVER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 PARKER DR
ANDOVER OH
44003-9481
US

IV. Provider business mailing address

104 PARKER DR
ANDOVER OH
44003-9481
US

V. Phone/Fax

Practice location:
  • Phone: 440-293-6600
  • Fax: 440-293-7394
Mailing address:
  • Phone: 440-293-6600
  • Fax: 440-293-7394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MRS. MIRANDA ROUGEOU
Title or Position: FINANCIAL OPERATIONS/CONTROLLER
Credential:
Phone: 440-293-6600