Organization
MED-CARE CONVALESCENT SUPPLY CO. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLLIAM T HOPWOOD OWNER (OWNER)
(937) 236-0527
Entity
Organization
Contact information
Practice address
109 AVONDALE DR, DAYTON, OH 45404-2123
(937) 236-0527
(937) 237-9192
Mailing address
109 AVONDALE DR, DAYTON, OH 45404-2123
(937) 236-0527
(937) 237-9192
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
57-154864
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0660164
—
OH
Enumeration date
05/18/2007
Last updated
08/22/2020
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