Organization Active NPI

Boardman Medical Supply Co

  • Durable Medical Equipment & Medical Supplies
  • Beachwood, OH
National Provider Identifier
1972663565
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
BOARDMAN MEDICAL SUPPLY CO
Practice address
24000 Mercantile Rd
Suite 6
Beachwood, OH 44122-5913
Phone
(330) 998-6012
Fax
(330) 998-6616
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ms. Robin S Ivany
Title
Vice President
Phone
(330) 545-6700

Specialties & licenses 1

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

Addresses

Primary practice location

24000 Mercantile Rd
Suite 6
Beachwood, OH 44122-5913

Mailing address

300 N State St
Girard, OH 44420-2538
Phone (330) 545-6700

Other identifiers 1

IdentifierTypeStateIssuer
2627732MedicaidOH

National Provider Directory

National Provider Directory

Locations

24000 Mercantile Rd
Ste 6
Beachwood, OH 44122
Phone (330) 998-6012

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1972663565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N STATE ST",
            "city": "GIRARD",
            "state": "OH",
            "postal_code": "444202538",
            "telephone_number": "330-545-6700",
            "fax_number": "330-545-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24000 MERCANTILE RD",
            "address_2": "SUITE 6",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225913",
            "telephone_number": "330-998-6012",
            "fax_number": "330-998-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARDMAN MEDICAL SUPPLY CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "IVANY",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "330-545-6700",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2627732",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.