Healthcare Provider Details

I. General information

NPI: 1124035092
Provider Name (Legal Business Name): DJMM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 10/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1132 S BURDICK ST
KALAMAZOO MI
49001
US

IV. Provider business mailing address

5027 HEATHROW
KALAMAZOO MI
49009-7738
US

V. Phone/Fax

Practice location:
  • Phone: 269-373-1753
  • Fax:
Mailing address:
  • Phone: 269-373-1753
  • Fax: 269-226-9834

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: MR. DAVID JOHN SCOTT
Title or Position: OWNER
Credential:
Phone: 269-373-1753