Organization
LOGAN VIEW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA GUMP (CHIEF OPERATING OFFICER)
(937) 593-0245
Entity
Organization
Contact information
Practice address
110 DOWELL AVE, BELLEFONTAINE, OH 43311-2305
(937) 593-2100
Mailing address
110 DOWELL AVE, BELLEFONTAINE, OH 43311-2305
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
HMEL.11005
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0567159
—
OH
Enumeration date
03/22/2006
Last updated
09/20/2013
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