MR. KEITH ROBERT DEMETRO NPI 1508885757

NPI Information

NPI: 1508885757
Provider Name: MR. KEITH ROBERT DEMETRO
Classification: Contractor - 171WH0202X
Entity Type: Individual

Specialization: Home Modifications

Address:
5354 NEW CASTLE RD
LOWELLVILLE, OH
ZIP 44436
Phone: (330) 755-7090
Get Directions

MR. Keith Robert Demetro is a home modifications contractor in Lowellville, OH. MR. Keith Robert Demetro NPI is 1508885757. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5354 NEW CASTLE RD
LOWELLVILLE, OH
ZIP 44436
Phone: (330) 755-7090

The enumeration date for this NPI number is 7/19/2006 and was last updated on 8/1/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	171WH0202X	Contractor	Home Modifications		OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0842888	MEDICAID	OHIO
2	2059721	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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