Healthcare Provider Details

I. General information

NPI: 1578589032
Provider Name (Legal Business Name): UNIVERSAL MEDICAL EQUIPMENT & SUPPLIES,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21700 GREENFIELD RD STE. 210
OAK PARK MI
48237-2581
US

IV. Provider business mailing address

21700 GREENFIELD RD STE. 210
OAK PARK MI
48237-2581
US

V. Phone/Fax

Practice location:
  • Phone: 248-968-5898
  • Fax: 248-968-5939
Mailing address:
  • Phone: 248-968-5898
  • Fax: 248-968-5939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number5979070001
License Number StateMI

VIII. Authorized Official

Name: MR. CYRIL C. NWAGURU
Title or Position: PRESIDENT/CEO
Credential: MA,MSW,CSW,LMSW
Phone: 248-968-5898