Provider Demographics
NPI:1548403140
Name:ALL STATE MEDICAL EQUIPMENT & SUPPLIES INC
Entity Type:Organization
Organization Name:ALL STATE MEDICAL EQUIPMENT & SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RASHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-583-3933
Mailing Address - Street 1:4700 GREENFIELD RD STE DME
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-4124
Mailing Address - Country:US
Mailing Address - Phone:313-583-3933
Mailing Address - Fax:313-583-3934
Practice Address - Street 1:4700 GREENFIELD RD STE DME
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-4124
Practice Address - Country:US
Practice Address - Phone:313-583-3933
Practice Address - Fax:313-583-3934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-13
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI02173R332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1548403140 FAOMedicaid
MI540E009590OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI540E009590OtherBLUE CROSS BLUE SHIELD OF MICHIGAN