Boardman Medical Supply Co

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

BOARDMAN MEDICAL SUPPLY CO

Practice address

1309 E Market St
Warren, OH 44483-6607

Phone

(330) 395-7252

Fax

(330) 373-1190

NPI assigned

Dec 12, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Robin S. Ivany

Title

Vice President

Phone

(330) 545-6700

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1073673653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N STATE ST",
            "city": "GIRARD",
            "state": "OH",
            "postal_code": "444202538",
            "telephone_number": "330-545-6700",
            "fax_number": "330-545-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444836607",
            "telephone_number": "330-395-7252",
            "fax_number": "330-373-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARDMAN MEDICAL SUPPLY CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2022-07-21",
        "certification_date": "2020-12-08",
        "status": "A",
        "authorized_official_last_name": "IVANY",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "330-545-6700",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2627714",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aron Blecher, M.D.
• Carrie Anne Blissenbach, WHNP-BC
• Michelle Lynn Blower, PHARMD
• Mercedes Blue
• Melody Camille Boals
• Gregory Boccieri, RPH
• Jane Boden, PTA
• Bradley Boggs, CPRS
• Bridgett Bogunia
• Allyssa Bohanan

• All providers in Warren, OH
• Durable Medical Equipment & Medical Supplies in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.