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General NPI Number Information
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NPI Number | 1033441043
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Entity Type | Organization
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Legal Business Name | EUCLID BUCKEYE MEDICAL SUPPLY CO. LLC
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Dates
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Enumeration Date | 02/02/2010
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Last Update Date | 02/02/2010
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Provider Practice Location Address
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Address Line | 26200 SHOREVIEW AVE
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City | EUCLID
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State | OH
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Zip | 44132-1453
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Country | US
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Telephone | 216-288-6962
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Fax | 216-732-7205
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Provider Business Mailing Address
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Address Line | 26200 SHOREVIEW AVE
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City | EUCLID
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State | OH
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Zip | 44132-1453
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Country | US
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Telephone | 216-288-6962
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Fax | 216-732-7205
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHALONDA NICOLE JOHNSON
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Credential |
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Telephone | 216-288-6962
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number |
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number |
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 332B00000X
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License Number State | OH
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