MEDICARE: FIDELITY MEDICAL PRODUCTS LLC

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

General Provider Information

NPI Number	:	1689859860
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIDELITY MEDICAL PRODUCTS LLC

Provider Business Mailing Address
First Line	:	3366 RIVERSIDE DR
Second Line	:	SUITE 104
City	:	COLUMBUS
State	:	OH
Zip	:	43221-1734
Country	:	US
Telephone Number	:	614-459-3749
Fax Number	:	614-459-8749

Provider Business Practice Location Address
First Line	:	3366 RIVERSIDE DR
Second Line	:	SUITE 104
City	:	COLUMBUS
State	:	OH
Zip	:	43221-1734
Country	:	US
Telephone Number	:	614-459-3749
Fax Number	:	614-459-8749

Authorized Official
Title or Position	:	COO
Name	:	MR. DOUGLAS S PAPLACZYK
Credential	:
Telephone Number	:	614-459-3749

Provider Enumeration Date	:	01/07/2008
Last Update Date	:	11/05/2008

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