Basic Information
Provider Information
NPI: 1487088910
EntityType: 2
ReplacementNPI:  
OrganizationName: PROCAIR, INC
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Mailing Information
Address1: 24000 BROADWAY AVE
Address2:  
City: OAKWOOD VILLAGE
State: OH
PostalCode: 441466329
CountryCode: US
TelephoneNumber: 4402323000
FaxNumber: 4407352260
Practice Location
Address1: 22566 FISHER RD
Address2:  
City: WATERTOWN
State: NY
PostalCode: 136011050
CountryCode: US
TelephoneNumber: 3157881725
FaxNumber: 3157880987
Other Information
ProviderEnumerationDate: 09/03/2013
LastUpdateDate: 09/03/2013
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: LOWERY
AuthorizedOfficialFirstName: WARREN
AuthorizedOfficialMiddleName: DARREL
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 4402323000
IsSoleProprietor:  
IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332B00000X  N SuppliersDurable Medical Equipment & Medical Supplies 
332BP3500X  N SuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
332BX2000X  Y SuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies

No ID Information.


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