Provider Demographics
NPI:1578589032
Name:UNIVERSAL MEDICAL EQUIPMENT & SUPPLIES,INC.
Entity Type:Organization
Organization Name:UNIVERSAL MEDICAL EQUIPMENT & SUPPLIES,INC.
Other - Org Name:UNIVERSAL MEDICAL EQUIPMENT & SUPPLIES COMPANY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CYRIL
Authorized Official - Middle Name:C
Authorized Official - Last Name:NWAGURU
Authorized Official - Suffix:
Authorized Official - Credentials:MA,MSW,CSW,LMSW
Authorized Official - Phone:248-968-5898
Mailing Address - Street 1:21700 GREENFIELD RD
Mailing Address - Street 2:STE. 210
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-2581
Mailing Address - Country:US
Mailing Address - Phone:248-968-5898
Mailing Address - Fax:248-968-5939
Practice Address - Street 1:21700 GREENFIELD RD
Practice Address - Street 2:STE. 210
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-2581
Practice Address - Country:US
Practice Address - Phone:248-968-5898
Practice Address - Fax:248-968-5939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5979070001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4702880Medicaid
MI5979070001Medicare NSC