Provider Demographics
NPI:1518093764
Name:EVERGREEN MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:EVERGREEN MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:USMAN
Authorized Official - Middle Name:SHAUKAT
Authorized Official - Last Name:BUTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-637-3188
Mailing Address - Street 1:1787 W BIG BEAVER RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3510
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1787 W BIG BEAVER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3510
Practice Address - Country:US
Practice Address - Phone:248-637-3188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies