Provider Demographics
NPI:1942277892
Name:MEDIEQUIP, INC.
Entity Type:Organization
Organization Name:MEDIEQUIP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:INGERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-830-1660
Mailing Address - Street 1:8428 N LINDBERGH BLVD
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-7136
Mailing Address - Country:US
Mailing Address - Phone:314-830-1660
Mailing Address - Fax:314-373-5304
Practice Address - Street 1:8428 N LINDBERGH BLVD
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-7136
Practice Address - Country:US
Practice Address - Phone:314-830-1660
Practice Address - Fax:314-373-5304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-28
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO629730508Medicaid
MO629730508Medicaid