Provider Demographics
NPI:1073690350
Name:MIDWEST D.M.E. SUPPLY, INC.
Entity Type:Organization
Organization Name:MIDWEST D.M.E. SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AMARJI
Authorized Official - Middle Name:
Authorized Official - Last Name:GHUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-538-8429
Mailing Address - Street 1:29226 ORCHARD LAKE RD
Mailing Address - Street 2:STE 160
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2984
Mailing Address - Country:US
Mailing Address - Phone:248-538-8429
Mailing Address - Fax:248-538-8362
Practice Address - Street 1:29226 ORCHARD LAKE RD
Practice Address - Street 2:STE 160
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2984
Practice Address - Country:US
Practice Address - Phone:248-538-8429
Practice Address - Fax:248-538-8362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4645756Medicaid
MI54-OF32237-0OtherBCBS
MI=========OtherPPOM
MI4645756Medicaid
MI=========OtherHAP