Provider Demographics
NPI:1316099641
Name:DARRELL W HARDIN INC
Entity type:Organization
Organization Name:DARRELL W HARDIN INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERAK-HARDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-346-8909
Mailing Address - Street 1:34950 CHARDON RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-9162
Mailing Address - Country:US
Mailing Address - Phone:440-269-1166
Mailing Address - Fax:440-269-1184
Practice Address - Street 1:34950 CHARDON RD
Practice Address - Street 2:SUITE 103
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-9162
Practice Address - Country:US
Practice Address - Phone:440-269-1166
Practice Address - Fax:440-269-1184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156FX1700X, 229N00000X
OH25-0332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty
No156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularistGroup - Multi-Specialty
No229N00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersAnaplastologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3898180001Medicare NSC