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Organization

MASSILLON CABLE TV, INC

Active
Other names
Safeguard
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GARY D LYON (GM SAFEGUARD)
(330) 833-4134
Entity
Organization

Contact information

Practice address
814 CABLE CT NW, MASSILLON, OH 44647-4284
(330) 833-4134
(330) 809-0222
Mailing address
PO BOX 239, MASSILLON, OH 44648-0239
(330) 833-4134
(330) 809-0222

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
312242798
MEDICAID PASSPORT PROVIDER - ODA
OH
Enumeration date
10/17/2013
Last updated
03/25/2014
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