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General NPI Number Information
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NPI Number | 1003174152
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Entity Type | Organization
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Legal Business Name | DURAMAX MEDICAL SUPPLY, INC.
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Dates
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Enumeration Date | 04/26/2012
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Last Update Date | 03/13/2014
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Provider Practice Location Address
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Address Line | 9427 CONANT ST SUITE A
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City | HAMTRAMCK
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State | MI
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Zip | 48212-3689
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Country | US
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Telephone | 586-601-9618
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Fax | 860-631-9618
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Provider Business Mailing Address
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Address Line | 9427 CONANT ST SUITE A
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City | HAMTRAMCK
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State | MI
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Zip | 48212-3689
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Country | US
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Telephone | 586-601-9618
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Fax | 860-631-9618
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MS. MELISSA PHILLIPS
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Credential |
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Telephone | 586-601-9618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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