Provider Demographics
NPI:1811386717
Name:PLAGENS MEDICAL SUPPLY CONSULTANTS
Entity Type:Organization
Organization Name:PLAGENS MEDICAL SUPPLY CONSULTANTS
Other - Org Name:PLAGENS MEDICAL CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SHAREHOLDER/PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:T
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-398-0425
Mailing Address - Street 1:48679 ALPHA DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WIXOM
Mailing Address - State:MI
Mailing Address - Zip Code:48393-3455
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:48679 ALPHA DR
Practice Address - Street 2:SUITE 100
Practice Address - City:WIXOM
Practice Address - State:MI
Practice Address - Zip Code:48393-3455
Practice Address - Country:US
Practice Address - Phone:517-586-6000
Practice Address - Fax:517-586-6001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment