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NPI Code Detail

MEDICARE: ERIC J PAUL

MEDICARE: ERIC J PAUL
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
1332BC3200XCustomized Equipment (DME)36002415OH

General Provider Information

NPI Number : 1467621854
Entity Type Code : Organization
Provider Name (Legal Business Name) : ERIC J PAUL
Provider Business Mailing Address
First Line : 6693 N CHESTNUT ST STE 12B
Second Line :
City : RAVENNA
State : OH
Zip : 44266-3900
Country : US
Telephone Number : 330-297-1211
Fax Number : 330-297-6550
Provider Business Practice Location Address
First Line : 6693 N CHESTNUT ST STE 12B
Second Line :
City : RAVENNA
State : OH
Zip : 44266-3900
Country : US
Telephone Number : 330-297-1211
Fax Number : 330-297-6550
Authorized Official
Title or Position : OWNER
Name : ERIC JAN PAUL
Credential : DPM
Telephone Number : 330-297-1211
Provider Enumeration Date : 02/29/2008
Last Update Date : 01/13/2017

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