Organization
LORRAINE SURGICAL SUPPLY INC
Active
Other names
Shield Healthcare OH, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE SUOR (VP GENERAL MANAGER)
(661) 294-4200
Entity
Organization
Contact information
Practice address
17520 ENGLE LAKE DR STE A, MIDDLEBURG HEIGHTS, OH 44130-8360
(216) 281-4777
(216) 281-4940
Mailing address
27911 FRANKLIN PKWY, VALENCIA, CA 91355-4110
(661) 294-4200
(661) 294-1042
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000155418
ANTHEM BCBS
OH
01
—
0276786
BUREAU FOR CHILDREN WITH
OH
05
—
0276786
—
OH
05
—
792625100
—
MN
Enumeration date
03/15/2006
Last updated
01/14/2025
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