Healthcare Provider Details

I. General information

NPI: 1710919725
Provider Name (Legal Business Name): DIVERSIFIED MEDICAL PRODUCTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 03/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 COUNTY ROAD 26
MARENGO OH
43334-9776
US

IV. Provider business mailing address

PO BOX 286
MARENGO OH
43334-0286
US

V. Phone/Fax

Practice location:
  • Phone: 419-253-0611
  • Fax: 419-253-0711
Mailing address:
  • Phone: 419-253-0611
  • Fax: 419-253-0711

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: MRS. RHONDA MAPLES
Title or Position: PRESIDENT
Credential:
Phone: 419-253-0611