Provider Demographics
NPI:1083340715
Name:ME-SOBI DME LLC
Entity Type:Organization
Organization Name:ME-SOBI DME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:IFENUGA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:317-527-1665
Mailing Address - Street 1:8110 CRACKLING LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46259-7683
Mailing Address - Country:US
Mailing Address - Phone:708-674-7515
Mailing Address - Fax:
Practice Address - Street 1:2308 SHELBY ST STE B
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46203-4233
Practice Address - Country:US
Practice Address - Phone:317-527-1665
Practice Address - Fax:708-575-5275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies