Healthcare Provider Details

I. General information

NPI: 1972810463
Provider Name (Legal Business Name): D&R HOME MEDICAL SUPPLY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2010
Last Update Date: 09/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3029 WHIPPLE AVE NW
CANTON OH
44718-3026
US

IV. Provider business mailing address

3029 WHIPPLE AVE NW
CANTON OH
44718-3026
US

V. Phone/Fax

Practice location:
  • Phone: 330-477-4816
  • Fax: 330-477-3345
Mailing address:
  • Phone: 330-477-4816
  • Fax: 330-477-3345

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 Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State

VIII. Authorized Official

Name: MR. DENNIS CHARLES GATTUSO SR.
Title or Position: PARTNER
Credential:
Phone: 330-477-4816