Healthcare Provider Details

I. General information

NPI: 1225013014
Provider Name (Legal Business Name): MULLANEY MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 12/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6096 MONTGOMERY RD
CINCINNATI OH
45213-1618
US

IV. Provider business mailing address

6096 MONTGOMERY RD
CINCINNATI OH
45213-1618
US

V. Phone/Fax

Practice location:
  • Phone: 513-731-1400
  • Fax: 513-366-3484
Mailing address:
  • Phone: 513-731-1400
  • Fax: 513-366-3484

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 Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number02-602900
License Number StateOH

VIII. Authorized Official

Name: MR. THOMAS P MULLANEY
Title or Position: PRESIDENT
Credential: R.PH.
Phone: 513-731-1400