MEDICARE: SPECTRUM MEDICAL EQUIPMENT 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
1	332B00000X	Durable Medical Equipment & Medical Supplies		MI

General Provider Information

NPI Number	:	1982642369
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECTRUM MEDICAL EQUIPMENT INC.

Provider Business Mailing Address
First Line	:	27243 SOUTHFIELD RD
Second Line	:
City	:	LATHRUP VILLAGE
State	:	MI
Zip	:	48076-3406
Country	:	US
Telephone Number	:	248-559-5422
Fax Number	:	248-559-5426

Provider Business Practice Location Address
First Line	:	27243 SOUTHFIELD RD
Second Line	:
City	:	LATHRUP VILLAGE
State	:	MI
Zip	:	48076-3406
Country	:	US
Telephone Number	:	248-559-5422
Fax Number	:	248-559-5426

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ZAHIR SHAH
Credential	:	PHYSCIAL THERAPIST
Telephone Number	:	313-475-3575

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	12/04/2007

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