KELLYS ELITE BOUTIQUE, LLC (NPI# 1710282744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710282744 |
| Entity Type | Organization |
| Organization Name | KELLYS ELITE BOUTIQUE, LLC |
| Practice Address |
1869 Niles Cortland Rd., Ne Warren OH 44484 |
| Practice Telephone | 8774249655 |
| Practice Fax Number | 8664231145 |
| Mailing Telephone | 8774249655 |
| Mailing Fax Number | 8664231145 |
| Enumeration Date | 2011-01-23 |
| Last Update Date | 2012-09-17 |
| Authorized Official Name | KELLY FRANKO (MEMBER) |
| Authorized Official Telephone | 8774249655 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Street Address |
1869 NILES CORTLAND RD., NE |
| City | WARREN |
| State | OH |
| Zip Code | 44484 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205446283 | Jessica Toot | Behavior Technician | Oakwood Counseling Center LLC, 1704 North Road Se, Warren, OH 44484 | 2020-08-05 |
| 1558857060 | Quantina Louise Thomas | Home Health | 1548oak Knoll Se, Warren, OH 44484 | 2018-07-09 |
| 1033609706 | Justin A Houy | Massage Therapist | 8345 E. Market St. Suite C, The Chiropractic and Functional Neurology Center, Warren, OH 44484 | 2018-05-17 |
| 1679091359 | Ester Mae Butler | Nurse's Aide | 2228 Draper Avenue Se, Warren, OH 44484 | 2017-09-01 |
| 1477070811 | Amanda Lynn Heberling | Occupational Therapy Assistant | 8128 Kenyon Dr., Warren, OH 44484 | 2017-08-26 |
| 1790213650 | Joyce A Mechling | Licensed Practical Nurse | 2737 Youngstown Rd., Warren, OH 44484 | 2017-05-23 |
| 1598206898 | Stan Catullo | Substance Abuse Rehabilitation Facility | 2737 Youngstown Warren Road Se, Warren, OH 44484 | 2017-03-20 |
| 1679014054 | Pamela M Lang | Pharmacist | 1977 Niles Rd S.e., Genoa A Qol Healthcare Company, Warren, OH 44484 | 2017-03-17 |
| 1922454800 | Jeremy Michael Capetillo | Dentist | 8740 E Market St Ste 1, Warren, OH 44484 | 2016-05-10 |
| 1215311865 | Jessica Dawn Harris | Physical Therapy Assistant | 1926 Ridge Avenue, Warren, OH 44484 | 2015-07-14 |
| Find all providers in zip 44484 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538715636 | 3 Dove Medical Supplies | Durable Medical Equipment & Medical Supplies | 31201 Chicago Rd S Ste C101, Warren, MI 48093 | 2019-08-14 |
| 1831689405 | Rivana Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 4208 E 14 Mile Rd, Warren, MI 48092-4325 | 2018-05-18 |
| 1508367111 | Meijer, Inc. | Durable Medical Equipment & Medical Supplies | 25225 Schoenherr Rd, Warren, MI 48089 | 2018-02-28 |
| 1134629496 | Homepro Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 3200 E 12 Mile Rd Ste 203b, Warren, MI 48092-5621 | 2018-02-13 |
| 1538668272 | American Home Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 3200 E 12 Mile Rd Ste 200, Warren, MI 48092-5621 | 2018-02-08 |
| 1053834762 | Befitting You, LLC | Durable Medical Equipment & Medical Supplies | 28800 Ryan Rd Ste 325, Warren, MI 48092-4283 | 2017-07-25 |
| 1255737235 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 150 E Market St Ste 100, Warren, OH 44481-1141 | 2014-11-18 |
| 1801226063 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 29176 Van Dyke Ave, Warren, MI 48093-6764 | 2013-11-25 |
| 1780019463 | J M Clemente Co | Durable Medical Equipment & Medical Supplies | 180 N Park Ave, Warren, OH 44481-1126 | 2013-09-12 |
| 1770837296 | Michigan Home Exteriors | Durable Medical Equipment & Medical Supplies | 11444 Kaltz Ave, Warren, MI 48089 | 2012-11-06 |
| Find all providers in WARREN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.