Basic Information
| Provider Information | |||||||||
| NPI: | 1972554939 | ||||||||
| 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: | 24000 BROADWAY AVE | ||||||||
| Address2: | |||||||||
| City: | OAKWOOD VILLAGE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441466329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402323000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2006 | ||||||||
| LastUpdateDate: | 08/09/2017 | ||||||||
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| AuthorizedOfficialLastName: | MARX | ||||||||
| AuthorizedOfficialFirstName: | JOEL | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | CHAIRMAN | ||||||||
| AuthorizedOfficialTelephone: | 4407353240 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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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 | 3336L0003X | 2011015003 | OH | N | Suppliers | Pharmacy | Long Term Care Pharmacy | 332BX2000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies | Oxygen Equipment & Supplies |
ID Information
| ID | Type | State | Issuer | Description | 212919 | 01 | OH | ANTHEM BLUE CROSS BLUE SH | OTHER | 5850842 | 05 | OH | MEDICAID |