Active Lifestyle Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ACTIVE LIFESTYLE MEDICAL SUPPLY LLC

Practice address

3632 Apache St NW
Uniontown, OH 44685-8654

Phone

(440) 708-4557

NPI assigned

Jul 7, 2018

Last updated

May 11, 2024By 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

Ryan Casady

Title

Ceo

Phone

(330) 595-4240

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1530921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715385600000",
    "number": "1922594498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11180 PEACH GLEN AVE NW",
            "city": "UNIONTOWN",
            "state": "OH",
            "postal_code": "446856300",
            "telephone_number": "330-595-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3632 APACHE ST NW",
            "city": "UNIONTOWN",
            "state": "OH",
            "postal_code": "446858654",
            "telephone_number": "440-708-4557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIFESTYLE MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-07",
        "last_updated": "2024-05-11",
        "certification_date": "2024-05-11",
        "status": "A",
        "authorized_official_last_name": "CASADY",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "330-595-4240"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2024; 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.