Provider Demographics
NPI:1538117247
Name:CRESCENT MEDICAL EQUIPMENT INC.
Entity Type:Organization
Organization Name:CRESCENT MEDICAL EQUIPMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUKHSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:IMTIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-796-3338
Mailing Address - Street 1:24650 EUREKA RD
Mailing Address - Street 2:SUITE#105
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-5160
Mailing Address - Country:US
Mailing Address - Phone:734-992-8140
Mailing Address - Fax:734-992-8139
Practice Address - Street 1:24650 EUREKA RD
Practice Address - Street 2:SUITE#105
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-5160
Practice Address - Country:US
Practice Address - Phone:734-992-8140
Practice Address - Fax:734-992-8139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5693450001Medicare NSC