Healthcare Provider Details
I. General information
NPI: 1154523561
Provider Name (Legal Business Name): DOYLE MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/05/2007
Last Update Date: 04/08/2021
Certification Date: 04/08/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1397 COMMERCE DR SUITE 2
STOW OH
44224-1736
US
IV. Provider business mailing address
1397 COMMERCE DR SUITE 2
STOW OH
44224-1736
US
V. Phone/Fax
- Phone: 330-436-0048
- Fax: 330-436-0045
- Phone: 330-436-0048
- Fax: 330-436-0045
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BP3500X |
| Taxonomy | Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
TED
JOHN
STITZEL
Title or Position: VICE PRESIDENT
Credential:
Phone: 330-436-0048