Healthcare Provider Details

I. General information

NPI: 1760768303
Provider Name (Legal Business Name): REDEMPTION MEDICAL SUPPLY &EQUIPMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2011
Last Update Date: 10/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 N SAGINAW ST
FLINT MI
48503-1739
US

IV. Provider business mailing address

1319 N SAGINAW ST
FLINT MI
48503-1739
US

V. Phone/Fax

Practice location:
  • Phone: 407-406-9832
  • Fax: 810-767-9460
Mailing address:
  • Phone: 407-406-9832
  • Fax: 810-767-9460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: MR. NATHAN GREGORY
Title or Position: OWNER
Credential: SUPPLY
Phone: 407-406-9832