M&J Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

M&J MEDICAL SUPPLY

Practice address

1034 W Main St
Ravenna, OH 44266-2708

Phone

(330) 297-9450

Fax

(330) 297-9455

NPI assigned

Aug 13, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Michelle Ann Walter

Title

Owner

Phone

(330) 297-9450

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576713600000",
    "number": "1073526166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 W MAIN ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442662708",
            "telephone_number": "330-297-9450",
            "fax_number": "330-297-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 W MAIN ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442662708",
            "telephone_number": "330-297-9450",
            "fax_number": "330-297-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M&J MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A",
        "authorized_official_last_name": "WALTER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-297-9450",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2518387",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Lutz, LPCC-S
• Susan Lyden, CRNA
• Rabecca Lydick
• Heaven Neveah Lytle
• Nasir Stewart Lytle
• Angel Mack, SW-T
• Patricia Rose Mack
• Jeffery David Macmonigal
• Kelly Macmullin, LISW
• Carmela Macreno

• Durable Medical Equipment & Medical Supplies in Ravenna, OH
• Providers in Ravenna, OH by specialty
• Durable Medical Equipment & Medical Supplies in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.