Organization
ESSENTIAL MEDICAL SHOP, LLC
Active
Other names
Essential Medical Shop
Organization subpart
No
Provider details
NPI number
Authorized official
MR. YAKUB OLADELE (PRESIDENT)
(937) 890-0449
Entity
Organization
Contact information
Practice address
8385 N MAIN ST, DAYTON, OH 45415-1602
(937) 890-0449
(937) 890-0454
Mailing address
8385 N MAIN ST, DAYTON, OH 45415-1602
(937) 890-0449
(937) 890-0454
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
HMEL 11687
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HMEL 11687
STATE LICENSE
OH
Enumeration date
05/19/2015
Last updated
05/19/2015
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