Provider Demographics
NPI:1477649838
Name:VITAL MEDICAL EQUIPMENT & SUPPLIES INC
Entity Type:Organization
Organization Name:VITAL MEDICAL EQUIPMENT & SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-569-1870
Mailing Address - Street 1:28165 GREENFIELD RD
Mailing Address - Street 2:SUITE 214
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076
Mailing Address - Country:US
Mailing Address - Phone:248-569-1870
Mailing Address - Fax:248-569-3621
Practice Address - Street 1:28165 GREENFIELD RD
Practice Address - Street 2:SUITE 214
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076
Practice Address - Country:US
Practice Address - Phone:248-569-1870
Practice Address - Fax:248-569-3621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5215790001Medicare ID - Type Unspecified