Healthcare Provider Details

I. General information

NPI: 1780357764
Provider Name (Legal Business Name): 365 DME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9860 HUDSON RD
PITTSFORD MI
49271-9861
US

IV. Provider business mailing address

9860 HUDSON RD
PITTSFORD MI
49271-9861
US

V. Phone/Fax

Practice location:
  • Phone: 517-997-5938
  • Fax: 855-978-1450
Mailing address:
  • Phone: 517-997-5938
  • Fax: 855-978-1450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: ROBYN JONES
Title or Position: OWNER
Credential:
Phone: 517-997-5938