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General NPI Number Information
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NPI Number | 1417429192
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Entity Type | Organization
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Legal Business Name | 121 MEDEQUIP INC
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Dates
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Enumeration Date | 12/19/2018
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Last Update Date | 04/03/2020
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Provider Practice Location Address
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Address Line | 13455 HALL RD
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City | UTICA
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State | MI
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Zip | 48315-5836
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Country | US
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Telephone | 734-756-0610
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Fax |
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Provider Business Mailing Address
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Address Line | 13455 HALL RD
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City | UTICA
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State | MI
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Zip | 48315-5836
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Country | US
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Telephone | 734-756-0610
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Fax |
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | RASHAD KHAN
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Credential |
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Telephone | 734-756-0610
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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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