Provider Demographics
NPI:1568631075
Name:DMERX DIRECT
Entity Type:Organization
Organization Name:DMERX DIRECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:LATHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-437-8471
Mailing Address - Street 1:105 S STATE ST
Mailing Address - Street 2:#602
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-5419
Mailing Address - Country:US
Mailing Address - Phone:909-437-8471
Mailing Address - Fax:801-315-6806
Practice Address - Street 1:96 N 1800 W
Practice Address - Street 2:#13
Practice Address - City:LINDON
Practice Address - State:UT
Practice Address - Zip Code:84042-1680
Practice Address - Country:US
Practice Address - Phone:909-437-8471
Practice Address - Fax:801-315-6806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies