Provider Demographics
NPI:1740229657
Name:MEDI-QUIP, INC.
Entity Type:Organization
Organization Name:MEDI-QUIP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:T
Authorized Official - Last Name:BEUERLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-762-5112
Mailing Address - Street 1:111 N COLUMBIA AVE
Mailing Address - Street 2:STE A
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-3353
Mailing Address - Country:US
Mailing Address - Phone:931-762-5112
Mailing Address - Fax:931-766-0842
Practice Address - Street 1:111 N COLUMBIA AVE
Practice Address - Street 2:STE A
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-3353
Practice Address - Country:US
Practice Address - Phone:931-762-5112
Practice Address - Fax:931-766-0842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3518854Medicaid
TN3518854Medicaid