Provider Demographics
NPI:1518319391
Name:EQUIPPE, INC.
Entity Type:Organization
Organization Name:EQUIPPE, INC.
Other - Org Name:EQUIPPE MOBILITY RESOURCES.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:DOKMANOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:RN ATP
Authorized Official - Phone:317-807-6789
Mailing Address - Street 1:3209 W SMITH VALLEY RD
Mailing Address - Street 2:SUITE 146
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-8495
Mailing Address - Country:US
Mailing Address - Phone:317-807-6789
Mailing Address - Fax:317-300-7116
Practice Address - Street 1:3209 W SMITH VALLEY RD
Practice Address - Street 2:SUITE 146
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-8495
Practice Address - Country:US
Practice Address - Phone:317-807-6789
Practice Address - Fax:317-300-7116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-06
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN7572750001Medicare NSC