Healthcare Provider Details

I. General information

NPI: 1871355511
Provider Name (Legal Business Name): INCLUSIONMD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2024
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24350 JOY RD STE 4B
REDFORD MI
48239-1265
US

IV. Provider business mailing address

490 NEWBURNE POINTE
BLOOMFIELD HILLS MI
48304-1409
US

V. Phone/Fax

Practice location:
  • Phone: 248-833-8338
  • Fax:
Mailing address:
  • Phone: 248-833-8338
  • Fax:

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 Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: VINCENT BERRY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 248-833-8222