Organization
BANNER HOME MEDICAL SUPPLY L.L.C
Active
Other names
Marc S. Banner SR.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARC STEPHAN BANNER (PRIMARY OWNER)
(937) 482-0042
Entity
Organization
Contact information
Practice address
67 E DAYTON YELLOW SPRINGS RD, FAIRBORN, OH 45324-3445
(937) 754-1210
(937) 482-0041
Mailing address
67 E DAYTON YELLOW SPRINGS RD, FAIRBORN, OH 45324-3445
(937) 754-1210
(937) 482-0041
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
HMEP33019
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2561731
—
OH
Enumeration date
12/13/2005
Last updated
08/22/2020
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