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General NPI Number Information
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NPI Number | 1447207204
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Entity Type | Organization
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Legal Business Name | MEDIC-AIR RESPIRATORY AND MEDICAL SUPPLIES, LLC
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 440 BURROUGHS ST 119
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City | DETROIT
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State | MI
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Zip | 48202-3429
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Country | US
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Telephone | 313-262-7243
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Fax | 313-262-7254
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Provider Business Mailing Address
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Address Line | 440 BURROUGHS ST 119
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City | DETROIT
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State | MI
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Zip | 48202-3429
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Country | US
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Telephone | 313-262-7243
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Fax | 313-262-7254
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Authorized Official
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Title or Position | OWNER
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Name | MS. HYLA REGENIA CLARK
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Credential |
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Telephone | 313-262-7243
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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 | 332B00000X
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 332BX2000X
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License Number State | MI
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