Healthcare Provider Details

I. General information

NPI: 1982170791
Provider Name (Legal Business Name): NORTHERN OHIO MEDICAL SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2018
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 BOARDMAN CANFIELD RD
BOARDMAN OH
44512-4004
US

IV. Provider business mailing address

PO BOX 8372
CAROL STREAM IL
60197-8372
US

V. Phone/Fax

Practice location:
  • Phone: 330-758-8808
  • Fax: 330-758-4288
Mailing address:
  • Phone: 419-609-1112
  • Fax: 419-609-1123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: RICHARD SCHNEIDER
Title or Position: CEO
Credential:
Phone: 419-451-3869