Northern Ohio Medical Specialists, LLC

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

NPI 1760022669 · NPPES record last updated Jan 9, 2020

Key facts

NPI
1760022669
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
Legal business name
NORTHERN OHIO MEDICAL SPECIALISTS, LLC
Practice address
24 Hyde St
Wakeman, OH 44889-9301
Phone
(440) 839-0039
Fax
(419) 660-0098
NPI assigned
Jan 9, 2020
Organization subpart
No

Authorized official

Name
Joshua Frederick
Title
Ceo
Phone
(419) 626-6161

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200324000890 OH DME Supplier - Physician - Podiatry 2769386192 Practice locations: Wakeman, OH

National Provider Directory

Specialties & licenses

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

Addresses

Primary practice location

24 Hyde St
Wakeman, OH 44889-9301

Mailing address

PO Box 378
Sandusky, OH 44871-0378
Phone (419) 626-6161

Other identifiers

IdentifierTypeStateIssuer
2253556MedicaidOH

Other names

  • NOMS Healthcare Doing business as

Other providers in Wakeman, OH

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

Sources for this page

Verify at the official NPI Registry.