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General NPI Number Information
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NPI Number | 1073776225
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Entity Type | Organization
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Legal Business Name | DIRECT MEDICAL, INCORPORATED
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Dates
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Enumeration Date | 07/08/2008
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Last Update Date | 07/13/2023
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Provider Practice Location Address
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Address Line | 335 W MAIN ST
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City | BELLEVILLE
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State | IL
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Zip | 62220-1505
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Country | US
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Telephone | 866-710-7679
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Fax |
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Provider Business Mailing Address
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Address Line | 335 W MAIN ST
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City | BELLEVILLE
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State | IL
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Zip | 62220-1505
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Country | US
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Telephone | 866-710-7679
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OPERATIONS
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Name | JOEL MICHAEL FUTERER
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Credential |
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Telephone | 310-293-5197
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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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