Active NPI
M & R of Fredricktown LTD. Inc.
- Durable Medical Equipment & Medical Supplies
- Canton, OH
National Provider Identifier
1043364003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 76-145095
- Legal business name
- M & R OF FREDRICKTOWN LTD. INC.
- Practice address
- 4031 Hills and Dales Rd NW
Canton, OH 44708-1659 - Phone
- (330) 478-3288
- Fax
- (330) 478-3821
- NPI assigned
- Jan 23, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Michael Houska
- Title
- President
- Phone
- (330) 478-3288
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 76-145095 | OH | Primary |
Addresses
Primary practice location
4031 Hills and Dales Rd NW
Canton, OH 44708-1659
Mailing address
4031 Hills and Dales Rd NW
Canton, OH 44708-1659
Phone (330) 478-3288
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2263821 | Medicaid | OH |
Other names 1
- MEDICAL SOLUTIONS & SUPPLIES
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930006091 | OH | DME Supplier - Medical Supply Company With Pedorthic Personnel | 2860503158 | Practice locations: Canton, OH |
National Provider Directory
National Provider Directory- Tax ID family
- M R of Fredricktown LTD Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Fairview Park, OH
- NPI 1194920215
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1254441600000",
"number": "1043364003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4031 HILLS AND DALES RD NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447081659",
"telephone_number": "330-478-3288",
"fax_number": "330-478-3821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4031 HILLS AND DALES RD NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447081659",
"telephone_number": "330-478-3288",
"fax_number": "330-478-3821"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "M & R OF FREDRICKTOWN LTD. INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-23",
"last_updated": "2009-10-02",
"status": "A",
"authorized_official_last_name": "HOUSKA",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "330-478-3288",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "OH",
"license": "76-145095",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2263821",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "MEDICAL SOLUTIONS & SUPPLIES",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.