Organization
PATRIOT MEDICAL SUPPLIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHALLE JENDRUSIK (PRESIDENT)
(740) 635-1602
Entity
Organization
Contact information
Practice address
253 N LINCOLN AVE, SUITE 100, BRIDGEPORT, OH 43912-1645
(740) 635-1605
(740) 635-1605
Mailing address
253 N LINCOLN AVE, SUITE 100, BRIDGEPORT, OH 43912-1645
(740) 635-1605
(740) 635-1605
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
HMEL11103
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2536525
—
OH
Enumeration date
01/16/2007
Last updated
08/22/2020
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