Basic Information
Provider Information
NPI: 1477046514
EntityType: 2
ReplacementNPI:  
OrganizationName: MEDICAL SERVICE COMPANIES
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
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Mailing Information
Address1: 24000 BROADWAY AVE
Address2:  
City: OAKWOOD VILLAGE
State: OH
PostalCode: 441466329
CountryCode: US
TelephoneNumber: 4402323000
FaxNumber: 4402323411
Practice Location
Address1: 7173 E 87TH ST
Address2:  
City: INDIANAPOLIS
State: IN
PostalCode: 462561204
CountryCode: US
TelephoneNumber: 3174195950
FaxNumber: 3174195955
Other Information
ProviderEnumerationDate: 06/13/2018
LastUpdateDate: 06/13/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BUNN
AuthorizedOfficialFirstName: JUDITH
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: COMPLIANCE MANAGER
AuthorizedOfficialTelephone: 4402323000
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: MEDICAL SERVICE COMPANIES
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332BX2000X  Y SuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies

No ID Information.


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