Healthcare Provider Details

I. General information

NPI: 1376512194
Provider Name (Legal Business Name): LORRAINE SURGICAL SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17520 ENGLE LAKE DR STE A
MIDDLEBURG HEIGHTS OH
44130-8360
US

IV. Provider business mailing address

27911 FRANKLIN PKWY
VALENCIA CA
91355-4110
US

V. Phone/Fax

Practice location:
  • Phone: 216-281-4777
  • Fax: 216-281-4940
Mailing address:
  • Phone: 661-294-4200
  • Fax: 661-294-1042

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 Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. MIKE SUOR
Title or Position: VP GENERAL MANAGER
Credential:
Phone: 661-294-4200