Provider Demographics
NPI:1437194164
Name:CALMED MEDICAL SUPPLIES & REPAIR, INC.
Entity Type:Organization
Organization Name:CALMED MEDICAL SUPPLIES & REPAIR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BENTZION
Authorized Official - Middle Name:
Authorized Official - Last Name:OSEROFF
Authorized Official - Suffix:
Authorized Official - Credentials:ABC LICENSED
Authorized Official - Phone:248-440-6069
Mailing Address - Street 1:24123 GREENFIELD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3124
Mailing Address - Country:US
Mailing Address - Phone:248-440-6069
Mailing Address - Fax:248-440-0107
Practice Address - Street 1:24123 GREEENFIELD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3125
Practice Address - Country:US
Practice Address - Phone:248-440-6069
Practice Address - Fax:248-440-0107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4957680001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4577478Medicaid
MI4577478Medicaid
MI=========TOtherBCBS PROVIDER NUMBER