Banner Home Medical Supply L.L.C

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

HMEP33019 Issued in OH

Legal business name

BANNER HOME MEDICAL SUPPLY L.L.C

Practice address

67 E Dayton Yellow Springs Rd
Fairborn, OH 45324-3445

Phone

(937) 754-1210

Fax

(937) 482-0041

NPI assigned

Dec 13, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Marc Stephan Banner

Title

Primary Owner

Phone

(937) 482-0042

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Marc S. Banner SR. Other name

Locations

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528043593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 E DAYTON YELLOW SPRINGS RD",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453243445",
            "telephone_number": "937-754-1210",
            "fax_number": "937-482-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 E DAYTON YELLOW SPRINGS RD",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453243445",
            "telephone_number": "937-754-1210",
            "fax_number": "937-482-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER HOME MEDICAL SUPPLY L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BANNER",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "STEPHAN",
        "authorized_official_title_or_position": "PRIMARY OWNER",
        "authorized_official_telephone_number": "937-482-0042",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OH",
            "license": "HMEP33019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2561731",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marc S. Banner SR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Imani Mari Baker
• Marie Baker
• Natalie Baldinelli, MS CFY-SLP
• Jordan Balser
• Esquire T Banks, QMHS
• Lashanna Barber
• Sheryl Ann Barnett, PTA
• Kaitlyn Marie Barone
• Christina Barr, BCBA
• Darlene Barrett

• Durable Medical Equipment & Medical Supplies in Fairborn, OH
• Providers in Fairborn, 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 Aug 22, 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.