Healthcare Provider Details

I. General information

NPI: 1215241732
Provider Name (Legal Business Name): MEDX DISPENSING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2010
Last Update Date: 07/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1091 HAMILTON RD
ALPENA MI
49707-7719
US

IV. Provider business mailing address

486 S RIPLEY BLVD STE 213
ALPENA MI
49707-4008
US

V. Phone/Fax

Practice location:
  • Phone: 989-884-0256
  • Fax: 888-349-3652
Mailing address:
  • Phone: 989-884-0256
  • Fax: 888-349-3652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. MIKE EDWARD BITLER
Title or Position: PRESIDENT
Credential:
Phone: 989-884-0256