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General NPI Number Information
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NPI Number | 1932266079
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Entity Type | Organization
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Legal Business Name | MEDWARE L L C
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Dates
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Enumeration Date | 01/01/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 912 S OLD WOODWARD AVE
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City | BIRMINGHAM
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State | MI
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Zip | 48009-6721
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Country | US
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Telephone | 248-647-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 1961 HENRIETTA ST
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City | BIRMINGHAM
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State | MI
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Zip | 48009-4169
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Country | US
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Telephone | 248-808-1768
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Fax | 248-258-9173
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Authorized Official
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Title or Position | CEO
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Name | MS. ELLEN LYNNE BENNAGE
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Credential | DMEPOS
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Telephone | 248-808-1768
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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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