Healthcare Provider Details
I. General information
NPI: 1710679782
Provider Name (Legal Business Name): ROBUST MEDICAL DEVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/25/2023
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
625 KENMOOR AVE SE STE 350
GRAND RAPIDS MI
49546-2395
US
IV. Provider business mailing address
625 KENMOOR AVE SE STE 350
GRAND RAPIDS MI
49546-2395
US
V. Phone/Fax
- Phone: 248-416-1333
- Fax:
- Phone: 248-416-1333
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARK
DIME
Title or Position: MANAGER
Credential:
Phone: 248-416-1333