Healthcare Provider Details

I. General information

NPI: 1114231727
Provider Name (Legal Business Name): XCLUSIVE MEDICAL EQUIPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2010
Last Update Date: 06/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 N SAGINAW ST SUITE 202
PONTIAC MI
48342-2134
US

IV. Provider business mailing address

28 N SAGINAW ST SUITE 202
PONTIAC MI
48342-2134
US

V. Phone/Fax

Practice location:
  • Phone: 248-353-5500
  • Fax: 248-630-4393
Mailing address:
  • Phone: 248-353-5500
  • Fax: 248-630-4393

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: MRS. IRENA STEVANOVICH
Title or Position: OWNER
Credential:
Phone: 248-353-5500