Organization
IDEAL MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONID KRUPOVLYANSKIY (CEO)
(614) 238-0878
Entity
Organization
Contact information
Practice address
2872 WEST BROAD STREET STE 101, COLUMBUS, OH 43204-2645
(614) 238-0878
(614) 343-7110
Mailing address
2658 W BROAD ST STE 100, COLUMBUS, OH 43204-3329
(614) 238-0878
(614) 343-7110
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2562105
—
OH
05
—
2890108
—
OH
Enumeration date
10/27/2006
Last updated
08/28/2013
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