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NPI Code Detail

MEDICARE: MCPARK, INC.

MEDICARE: MCPARK, INC.
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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1861786337
Entity Type Code : Organization
Provider Name (Legal Business Name) : MCPARK, INC.
Provider Business Mailing Address
First Line : 55 E LONG LAKE RD
Second Line :
City : TROY
State : MI
Zip : 48085-4738
Country : US
Telephone Number : 248-866-7033
Fax Number : 248-584-5648
Provider Business Practice Location Address
First Line : 55 E LONG LAKE RD
Second Line :
City : TROY
State : MI
Zip : 48085-4738
Country : US
Telephone Number : 248-866-7033
Fax Number : 248-584-5648
Authorized Official
Title or Position : VICE PRESIDENT
Name : MR. GREGORY EUGENE PARKER
Credential :
Telephone Number : 248-866-7033
Provider Enumeration Date : 06/02/2011
Last Update Date : 06/02/2011

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