Provider Demographics
NPI:1396820551
Name:FEDERAL MEDICAL EQUIPMENT &SUPPLIES
Entity Type:Organization
Organization Name:FEDERAL MEDICAL EQUIPMENT &SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EDIE
Authorized Official - Middle Name:NEBA
Authorized Official - Last Name:FABS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-569-5568
Mailing Address - Street 1:15565 NORTHLAND DR W
Mailing Address - Street 2:STE. 917 E
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5305
Mailing Address - Country:US
Mailing Address - Phone:248-568-5568
Mailing Address - Fax:248-569-1229
Practice Address - Street 1:15565 NORTHLAND DR W
Practice Address - Street 2:STE. 917 E
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5303
Practice Address - Country:US
Practice Address - Phone:248-568-5568
Practice Address - Fax:248-569-1229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5653340001Medicare ID - Type Unspecified