Healthcare Provider Details

I. General information

NPI: 1255434205
Provider Name (Legal Business Name): PROGRESSIVE MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 05/15/2023
Certification Date: 05/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PROGRESSIVE WAY
WESTERVILLE OH
43082-9615
US

IV. Provider business mailing address

250 PROGRESSIVE WAY
WESTERVILLE OH
43082-9615
US

V. Phone/Fax

Practice location:
  • Phone: 614-794-3300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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 Code3336M0002X
TaxonomyMail Order Pharmacy
License NumberCPO.021781350-12
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ANGELA JENKINS
Title or Position: DIRECTOR OF REGULATORY COMPLIANCE
Credential:
Phone: 614-212-8264