Provider Demographics
NPI:1235163551
Name:BEVAL MEDICAL EQUIPMENT & SUPPLIES
Entity Type:Organization
Organization Name:BEVAL MEDICAL EQUIPMENT & SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-280-1818
Mailing Address - Street 1:4307 W 13 MILE RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6504
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:248-786-5362
Practice Address - Street 1:4307 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6504
Practice Address - Country:US
Practice Address - Phone:248-280-1818
Practice Address - Fax:248-786-5362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4922874Medicaid
MI540F335050OtherBLUE CROSS BLUE SHIELD
MI4922874Medicaid