MEDICARE: GROVE HOME MEDICAL, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000155612	OTHER	OH	ANTHEM #

General Provider Information

NPI Number	:	1003811084
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GROVE HOME MEDICAL, INC

Provider Business Mailing Address
First Line	:	849 BOULEVARD ST
Second Line	:
City	:	DOVER
State	:	OH
Zip	:	44622-2007
Country	:	US
Telephone Number	:	330-343-6153
Fax Number	:	330-364-1769

Provider Business Practice Location Address
First Line	:	849 BOULEVARD ST
Second Line	:
City	:	DOVER
State	:	OH
Zip	:	44622-2007
Country	:	US
Telephone Number	:	330-343-6153
Fax Number	:	330-364-1769

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. WILLIAM V GROVE
Credential	:
Telephone Number	:	330-343-6153

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	08/22/2020

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Directions to “GROVE HOME MEDICAL, INC ” Practice Location

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