MEDICARE: M M E AND SUPPLIES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)	5301007884	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	71020000E00726	OTHER	MI	BCBSM

General Provider Information

NPI Number	:	1417957390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M M E AND SUPPLIES INC

Provider Business Mailing Address
First Line	:	3731 E 10 MILE RD
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48091-3722
Country	:	US
Telephone Number	:	800-250-3885
Fax Number	:	586-756-5412

Provider Business Practice Location Address
First Line	:	3731 E 10 MILE RD
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48091-3722
Country	:	US
Telephone Number	:	800-250-3885
Fax Number	:	586-756-5412

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. NOAH CADLE
Credential	:
Telephone Number	:	800-250-3885

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	02/14/2011

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Directions to “M M E AND SUPPLIES INC ” Practice Location

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