Healthcare Provider Details

I. General information

NPI: 1578736658
Provider Name (Legal Business Name): HORVATH MEDICAL SUPPLY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2008
Last Update Date: 04/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9930 JOHNNYCAKE RIDGE RD UNIT 1C
MENTOR OH
44060-6752
US

IV. Provider business mailing address

7910 BATTLES RD
GATES MILLS OH
44040-9354
US

V. Phone/Fax

Practice location:
  • Phone: 440-357-2371
  • Fax: 440-357-2381
Mailing address:
  • Phone: 440-423-1921
  • Fax: 440-423-1522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberLP0051
License Number StateOH

VIII. Authorized Official

Name: MR. FERENCZ F HORVATH
Title or Position: LICENSED PROSTHETIST/OWNER
Credential: L.P.
Phone: 440-357-2371