Provider Demographics
NPI:1467487090
Name:TRI-COUNTY DME INC
Entity Type:Organization
Organization Name:TRI-COUNTY DME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:YOLANDE
Authorized Official - Middle Name:INGRID
Authorized Official - Last Name:STEPHENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-962-8072
Mailing Address - Street 1:PO BOX 623
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48037-0623
Mailing Address - Country:US
Mailing Address - Phone:313-962-8072
Mailing Address - Fax:313-962-8288
Practice Address - Street 1:660 WOODWARD AVE
Practice Address - Street 2:SUITE 1057
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-3516
Practice Address - Country:US
Practice Address - Phone:313-962-8072
Practice Address - Fax:313-962-8288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4478020001Medicare ID - Type UnspecifiedDURABLE MEDICAL EQUIPMENT