Healthcare Provider Details
I. General information
NPI: 1891988002
Provider Name (Legal Business Name): NEW MIDWEST MEDICAL EQUIPMENT AND SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/21/2007
Last Update Date: 08/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6792 STONEBRIDGE CT
WEST BLOOMFIELD MI
48322-3265
US
IV. Provider business mailing address
6792 STONEBRIDGE CT
WEST BLOOMFIELD MI
48322-3265
US
V. Phone/Fax
- Phone: 248-569-3134
- Fax: 248-569-8159
- Phone: 248-569-3134
- Fax: 248-569-8159
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MUHAMMED
REHMAN
Title or Position: PRESIDENT
Credential:
Phone: 248-569-3134