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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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2561731 | Medicaid | OH |
Other names
- Marc S. Banner SR.
Other providers in Fairborn, OH
- Kelsey Baker
- Marie Baker
- Natalie Baldinelli
- Jordan Balser
- Esquire T Banks
- Lashanna Barber
- Sheryl Ann Barnett
- Kaitlyn Marie Barone
- Christina Barr
- Darlene Barrett
All providers in Fairborn, OH · Durable Medical Equipment & Medical Supplies in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.