Organization
MIDDLE RIDGE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN ROTENBERRY (CFO)
(440) 239-4300
Entity
Organization
Contact information
Practice address
7530 LUCERNE DR, CLEVELAND, OH 44130-6587
(440) 239-4300
(440) 239-4301
Mailing address
7530 LUCERNE DR, CLEVELAND, OH 44130-6587
(440) 239-4300
(440) 239-4301
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0777459
—
OH
Enumeration date
09/30/2005
Last updated
08/22/2020
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