Healthcare Provider Details

I. General information

NPI: 1023925872
Provider Name (Legal Business Name): MEDCORE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5620 KENMOOR RD
BLOOMFIELD HILLS MI
48301-1016
US

IV. Provider business mailing address

5620 KENMOOR RD
BLOOMFIELD HILLS MI
48301-1016
US

V. Phone/Fax

Practice location:
  • Phone: 111-111-1111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MOUSTAFA ABDALLA
Title or Position: CEO
Credential:
Phone: 111-111-1111