Ideal Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

IDEAL MEDICAL SUPPLY INC

Practice address

2872 West Broad Street Ste 101
Columbus, OH 43204-2645

Phone

(614) 238-0878

Fax

(614) 343-7110

NPI assigned

Oct 27, 2006

Organization subpart

No

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

Authorized official

Name

Leonid Krupovlyanskiy

Title

Ceo

Phone

(614) 238-0878

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377648000000",
    "number": "1528144060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2658 W BROAD ST STE 100",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432043329",
            "telephone_number": "614-238-0878",
            "fax_number": "614-343-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2872 WEST BROAD STREET STE 101",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432042645",
            "telephone_number": "614-238-0878",
            "fax_number": "614-343-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2013-08-28",
        "status": "A",
        "authorized_official_last_name": "KRUPOVLYANSKIY",
        "authorized_official_first_name": "LEONID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "614-238-0878"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2562105",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2890108",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Id Med Inc.
• Shamso Yusuf Idd
• Ideal Adult Daycare Inc
• Ideal Care Providers
• Ideal Home Health Inc.
• Ideal Medical Supply Inc (Family Pharmacy)
• Alyssa Emani Ideis, CDCA
• Racheal Idowu
• Sumer Idries, LISW
• Syed Ali Shan Idris, M.D.; MBBS

• Durable Medical Equipment & Medical Supplies in Columbus, OH
• Providers in Columbus, 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 28, 2013; 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.