Healthcare Provider Details

I. General information

NPI: 1689687626
Provider Name (Legal Business Name): DAYTON HOME MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 04/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7682 MCEWEN RD
CENTERVILLE OH
45459
US

IV. Provider business mailing address

7682 MCEWEN RD
CENTERVILLE OH
45459
US

V. Phone/Fax

Practice location:
  • Phone: 937-291-9554
  • Fax: 937-291-9569
Mailing address:
  • Phone: 937-291-9554
  • Fax: 937-291-9569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberHMER22204
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberHMER22204
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberHMER22204
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateOH

VIII. Authorized Official

Name: NICK KALOGERAS
Title or Position: VP
Credential:
Phone: 614-294-1600