Healthcare Provider Details

I. General information

NPI: 1275604829
Provider Name (Legal Business Name): DOUG BROWN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6807 CASCADE RD SE STE C
GRAND RAPIDS MI
49546-6819
US

IV. Provider business mailing address

6807 CASCADE RD SE STE C
GRAND RAPIDS MI
49546-6819
US

V. Phone/Fax

Practice location:
  • Phone: 616-954-6598
  • Fax: 616-954-6679
Mailing address:
  • Phone: 616-954-6598
  • Fax: 616-954-6679

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: DOUGLAS BROWN
Title or Position: PRESIDENT
Credential:
Phone: 616-954-6598