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Organization Active NPI Durable Medical Equipment & Medical Supplies · Fairborn, OH

NPI 1528043593 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1528043593
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
License
HMEP33019 (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
Organization subpart
No

Authorized official

Name
Mr. Marc Stephan Banner
Title
Primary Owner
Phone
(937) 482-0042

National Provider Directory

Locations

67 E Dayton Yellow Springs Rd
Fairborn, OH 45324
Phone (937) 754-1210

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X HMEP33019 OH Yes

Addresses

Primary practice location

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

Mailing address

67 E Dayton Yellow Springs Rd
Fairborn, OH 45324-3445
Phone (937) 754-1210

Other identifiers

IdentifierTypeStateIssuer
2561731MedicaidOH

Other names

  • Marc S. Banner SR. Other name

Other providers in Fairborn, OH

All providers in Fairborn, OH · Durable Medical Equipment & Medical Supplies in Ohio

Sources for this page

Verify at the official NPI Registry.