MEDICARE: QUANTUM MEDICAL EQUIPMENT, L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	E11672	OTHER	MI	ARTICLES OF ORGANIZATION MICHIGAN E11672

General Provider Information

NPI Number	:	1033367503
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUANTUM MEDICAL EQUIPMENT, L.L.C.

Provider Business Mailing Address
First Line	:	2009 15 MILE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-4864
Country	:	US
Telephone Number	:	248-497-9739
Fax Number	:

Provider Business Practice Location Address
First Line	:	2009 15 MILE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-4864
Country	:	US
Telephone Number	:	248-497-9739
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARIBEL TRINIDAD
Credential	:	LPN
Telephone Number	:	248-497-9739

Provider Enumeration Date	:	09/08/2008
Last Update Date	:	09/08/2008

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