Healthcare Provider Details

I. General information

NPI: 1396891495
Provider Name (Legal Business Name): NATIONAL BIOLOGICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 06/16/2020
Certification Date: 06/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23700 MERCANTILE RD
BEACHWOOD OH
44122-5900
US

IV. Provider business mailing address

23700 MERCANTILE RD
BEACHWOOD OH
44122-5900
US

V. Phone/Fax

Practice location:
  • Phone: 216-831-0600
  • Fax: 216-765-0271
Mailing address:
  • Phone: 216-831-0600
  • Fax: 216-765-0271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number18501214
License Number StateOH

VIII. Authorized Official

Name: HALEY WHITE
Title or Position: VICE PRESIDENT
Credential:
Phone: 216-831-0600