Provider Demographics
NPI:1588850820
Name:MEDEQUIP, INC
Entity Type:Organization
Organization Name:MEDEQUIP, INC
Other - Org Name:MEDICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SOREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-443-4414
Mailing Address - Street 1:27 BROOKLINE
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-1461
Mailing Address - Country:US
Mailing Address - Phone:949-443-4414
Mailing Address - Fax:949-493-4754
Practice Address - Street 1:2755 S HIGHWAY 14
Practice Address - Street 2:SUITE 1200L
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-4902
Practice Address - Country:US
Practice Address - Phone:864-849-9144
Practice Address - Fax:864-849-9196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1588850820Medicaid
0718490003Medicare NSC