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General NPI Number Information
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NPI Number | 1407499981
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Entity Type | Organization
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Legal Business Name | NORTHERN OHIO MEDICAL SPECIALISTS, LLC
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Dates
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Enumeration Date | 10/28/2019
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Last Update Date | 10/28/2019
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Provider Practice Location Address
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Address Line | 26151 EUCLID AVE STE 105
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City | EUCLID
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State | OH
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Zip | 44132-3300
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Country | US
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Telephone | 440-442-3113
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Fax | 440-442-5137
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Provider Business Mailing Address
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Address Line | 3004 HAYES AVE
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City | SANDUSKY
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State | OH
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Zip | 44870-5321
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Country | US
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Telephone | 419-626-6161
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Fax | 419-502-3511
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Authorized Official
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Title or Position | CEO
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Name | JOSHUA FREDERICK
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Credential |
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Telephone | 419-626-6161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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