=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235139148
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SEELEY MEDICAL OXYGEN COMPANY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/21/2005
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 900 E 222ND ST
-----------------------------------------------------
City | EUCLID
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44123-3312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-261-9100
-----------------------------------------------------
Fax | 216-261-9103
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 104 PARKER DR
-----------------------------------------------------
City | ANDOVER
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44003-9481
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-293-6600
-----------------------------------------------------
Fax | 440-293-7394
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FINANCIAL OPERATIONS
-----------------------------------------------------
Name | LINDA FEE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 440-293-6600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BX2000X
-----------------------------------------------------
Taxonomy Name | Oxygen Equipment & Supplies (DME)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------