Provider Demographics
NPI:1528362639
Name:AMERICAN DME AND MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:AMERICAN DME AND MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAILA
Authorized Official - Middle Name:
Authorized Official - Last Name:RATHOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-560-7500
Mailing Address - Street 1:1107 S MISSION ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-3914
Mailing Address - Country:US
Mailing Address - Phone:989-772-2900
Mailing Address - Fax:989-772-2929
Practice Address - Street 1:1107 S MISSION ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-3914
Practice Address - Country:US
Practice Address - Phone:989-772-2900
Practice Address - Fax:989-772-2929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-04
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI03454K332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI03454KOtherENTITY ID FROM THE STATE OF MICHIGAN
MI03454KOtherENTITY ID FROM THE STATE OF MICHIGAN