Basic Information
| Provider Information | |||||||||
| NPI: | 1174708853 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEDICAL SERVICE COMPANIES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24000 BROADWAY AVE | ||||||||
| Address2: | |||||||||
| City: | OAKWOOD VILLAGE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441466329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402323000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 92 N. DIAMOND ST. | ||||||||
| Address2: | |||||||||
| City: | MANSFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195229900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/31/2007 | ||||||||
| LastUpdateDate: | 06/22/2018 | ||||||||
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| AuthorizedOfficialLastName: | MARX | ||||||||
| AuthorizedOfficialFirstName: | JOEL | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | CHAIRMAN | ||||||||
| AuthorizedOfficialTelephone: | 4402323000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | N | Suppliers | Durable Medical Equipment & Medical Supplies | 332BP3500X | N | Suppliers | Durable Medical Equipment & Medical Supplies | Parenteral & Enteral Nutrition | 332BX2000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies | Oxygen Equipment & Supplies |
ID Information
| ID | Type | State | Issuer | Description | 2806093 | 05 | OH | MEDICAID |