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General NPI Number Information
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NPI Number | 1336316967
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Entity Type | Organization
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Legal Business Name | MODERN MEDICAL INC
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 7840 GRAPHICS WAY POST OFFICE BOX 549
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City | LEWIS CENTER
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State | OH
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Zip | 43035-8002
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Country | US
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Telephone | 740-657-3330
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Fax | 740-657-3337
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Provider Business Mailing Address
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Address Line | 7840 GRAPHICS WAY POST OFFICE BOX 549
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City | LEWIS CENTER
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State | OH
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Zip | 43035-8002
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Country | US
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Telephone | 740-657-3330
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Fax | 740-657-3337
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. RAYMOND R. BLACK
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Credential |
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Telephone | 740-657-3330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | HMEP 33010
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License Number State | OH
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Taxonomy #5
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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 |
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Taxonomy #6
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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 |
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Taxonomy #7
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Taxonomy Code | 3416A0800X
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Taxonomy Name | Air Ambulance
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 3416S0300X
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Taxonomy Name | Water Ambulance
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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