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General NPI Number Information
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NPI Number | 1629174560
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Entity Type | Organization
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Legal Business Name | CARDINAL HOME MEDICAL INC.
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1387 MARLOWE AVE SUITE #6
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City | LAKEWOOD
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State | OH
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Zip | 44107-2676
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Country | US
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Telephone | 216-226-1112
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Fax | 216-226-2409
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Provider Business Mailing Address
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Address Line | 1387 MARLOWE AVE SUITE #6
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City | LAKEWOOD
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State | OH
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Zip | 44107-2676
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Country | US
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Telephone | 216-226-1112
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Fax | 216-226-2409
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Authorized Official
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Title or Position | SECRETARY/RESPIRATORY THERAPIST
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Name | MR. RICHARD LEE BENNETT
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Credential | R.R.T.
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Telephone | 216-226-1112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | HMEP 33005
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License Number State | OH
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