Boardman Medical Supply Co

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

BOARDMAN MEDICAL SUPPLY CO

Practice address

1204 30TH St NW
Canton, OH 44709-2923

Phone

(330) 492-4300

Fax

(330) 492-7886

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

Robin S Ivany

Title

Vice President/GM

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": "1607385600000",
    "number": "1164582748",
    "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": "1204 30TH ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447092923",
            "telephone_number": "330-492-4300",
            "fax_number": "330-492-7886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARDMAN MEDICAL SUPPLY CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-12-08",
        "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/GM",
        "authorized_official_telephone_number": "330-545-6700"
    },
    "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": "2627741",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Christine Blue
• Daniel S Blumer, D.O.
• Madison Marie Blyer
• Board of Education Canton City School District
• Board of Education Canton Local School District
• Lonnie Boatright, CRNA
• Samantha J. Boatwright, LPCC-S
• Maggie M. Bockoven, PCC
• Nancy Lou Bocook-Youngman, LPN
• Martha R Boedy, ST

• Durable Medical Equipment & Medical Supplies in Canton, OH
• Providers in Canton, 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 8, 2020; 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.