MEDICARE: M R MAIYER 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	HMEL 11029	OH
2	332BC3200X	Customized Equipment (DME)	HMEL 11029	OH
3	332BN1400X	Nursing Facility Supplies (DME)	HMEL 11029	OH
4	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	HMEL 11029	OH
5	332BX2000X	Oxygen Equipment & Supplies (DME)	HMEL 11029	OH
6	333600000X	Pharmacy	02-1165600	OH
7	3336L0003X	Long Term Care Pharmacy	02-1165600	OH
8	3336C0003X	Community/Retail Pharmacy	02-1165600	OH

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	3634715	OTHER		NABP NUMBER

General Provider Information

NPI Number	:	1760543268
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M R MAIYER INC

Provider Business Mailing Address
First Line	:	283 CLINE AVE
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44907-1019
Country	:	US
Telephone Number	:	419-756-6032
Fax Number	:	419-756-3041

Provider Business Practice Location Address
First Line	:	283 CLINE AVE
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44907-1019
Country	:	US
Telephone Number	:	419-756-6032
Fax Number	:	419-756-3041

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MATTHEW RYAN MAIYER
Credential	:	RPH
Telephone Number	:	419-756-6032

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	03/07/2023

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Directions to “M R MAIYER INC ” Practice Location

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