Provider Demographics
NPI:1427595958
Name:CENTRAL MICHIGAN MEDICAL TECHNOLOGIES, LLC
Entity Type:Organization
Organization Name:CENTRAL MICHIGAN MEDICAL TECHNOLOGIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-306-6189
Mailing Address - Street 1:6191 BEECHER RD
Mailing Address - Street 2:
Mailing Address - City:OSSEO
Mailing Address - State:MI
Mailing Address - Zip Code:49266-9672
Mailing Address - Country:US
Mailing Address - Phone:517-594-5049
Mailing Address - Fax:866-465-0269
Practice Address - Street 1:115 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:MI
Practice Address - Zip Code:49247-1301
Practice Address - Country:US
Practice Address - Phone:517-306-6189
Practice Address - Fax:866-465-0269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies