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

Organization subpart

No

Name

Ryan Casady

Title

Ceo

Phone

(330) 595-4240

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 11, 2024.

{
    "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.