Provider Demographics
NPI:1235727991
Name:EQUIP MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:EQUIP MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELI
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:RYTLEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-750-6064
Mailing Address - Street 1:33 S 5 MILE RD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-9015
Mailing Address - Country:US
Mailing Address - Phone:989-898-7967
Mailing Address - Fax:989-898-7968
Practice Address - Street 1:33 S 5 MILE RD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-9015
Practice Address - Country:US
Practice Address - Phone:989-898-7967
Practice Address - Fax:989-898-7968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-07
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies