Provider Demographics
NPI:1487829941
Name:REDEMPTIVE MEDICAL EQUIPMENT ,LLC
Entity Type:Organization
Organization Name:REDEMPTIVE MEDICAL EQUIPMENT ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SYNOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-778-1679
Mailing Address - Street 1:30550 GRATIOT AVE UNIT 247
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-6710
Mailing Address - Country:US
Mailing Address - Phone:586-498-7900
Mailing Address - Fax:877-218-4462
Practice Address - Street 1:16190 E 13 MILE RD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-1505
Practice Address - Country:US
Practice Address - Phone:586-498-7900
Practice Address - Fax:877-218-4462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6181450001Medicare NSC