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General NPI Number Information
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NPI Number | 1639214786
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Entity Type | Organization
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Legal Business Name | DIRECT MEDICAL EQUIPMENT
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 9282 GENERAL DR SUITE # 150
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City | PLYMOUTH
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State | MI
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Zip | 48170-4694
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Country | US
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Telephone | 734-451-1414
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Fax | 734-451-0404
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Provider Business Mailing Address
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Address Line | 9282 GENERAL DR SUITE # 150
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City | PLYMOUTH
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State | MI
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Zip | 48170-4694
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Country | US
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Telephone | 734-451-1414
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Fax | 734-451-0404
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANTHONY W POLLICELLA
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Credential |
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Telephone | 734-451-1414
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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 | MI
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State | MI
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