Organization
BOARDMAN MEDICAL SUPPLY CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROBIN S IVANY (VICE PRESIDENT)
(330) 545-6700
Entity
Organization
Contact information
Practice address
24000 MERCANTILE RD, SUITE 6, BEACHWOOD, OH 44122-5913
(330) 998-6012
(330) 998-6616
Mailing address
300 N STATE ST, GIRARD, OH 44420-2538
(330) 545-6700
(330) 545-5555
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2627732
—
OH
Enumeration date
12/12/2006
Last updated
07/21/2022
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