Healthcare Provider Details

I. General information

NPI: 1740395037
Provider Name (Legal Business Name): BOOMERS MEDICAL EQUIPMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 E WILSON BRIDGE RD STE A
WORTHINGTON OH
43085-2373
US

IV. Provider business mailing address

3750 PRIORITY WAY SOUTH DR
INDIANAPOLIS IN
46240-3831
US

V. Phone/Fax

Practice location:
  • Phone: 740-653-7070
  • Fax: 877-604-3468
Mailing address:
  • Phone: 740-653-7070
  • Fax: 877-604-3468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberHMER.22044
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberHMER.22044
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberHMER.22044
License Number StateOH

VIII. Authorized Official

Name: KEVIN GEARHEART
Title or Position: PRESIDENT
Credential:
Phone: 317-813-4210