Provider Demographics
NPI:1710679782
Name:ROBUST MEDICAL DEVICES
Entity Type:Organization
Organization Name:ROBUST MEDICAL DEVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:DIME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-416-1333
Mailing Address - Street 1:625 KENMOOR AVE SE STE 350
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-2395
Mailing Address - Country:US
Mailing Address - Phone:248-416-1333
Mailing Address - Fax:
Practice Address - Street 1:625 KENMOOR AVE SE STE 350
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-2395
Practice Address - Country:US
Practice Address - Phone:248-416-1333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies