Provider Demographics
NPI:1063480705
Name:HETCH-CO INC
Entity Type:Organization
Organization Name:HETCH-CO INC
Other - Org Name:RESIDENTIAL MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HETCHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-969-2266
Mailing Address - Street 1:3558 THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48371-1438
Mailing Address - Country:US
Mailing Address - Phone:248-969-2266
Mailing Address - Fax:248-969-9611
Practice Address - Street 1:3558 THOMAS RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MI
Practice Address - Zip Code:48371-1438
Practice Address - Country:US
Practice Address - Phone:248-969-2266
Practice Address - Fax:248-969-9611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-09
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI14501OtherM-CAID
MI2659645Medicaid
0452590001Medicare NSC