Provider Demographics
NPI:1982642369
Name:SPECTRUM MEDICAL EQUIPMENT INC.
Entity Type:Organization
Organization Name:SPECTRUM MEDICAL EQUIPMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ZAHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSCIAL THERAPIST
Authorized Official - Phone:313-475-3575
Mailing Address - Street 1:27243 SOUTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LATHRUP VILLAGE
Mailing Address - State:MI
Mailing Address - Zip Code:48076-3406
Mailing Address - Country:US
Mailing Address - Phone:248-559-5422
Mailing Address - Fax:248-559-5426
Practice Address - Street 1:27243 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:LATHRUP VILLAGE
Practice Address - State:MI
Practice Address - Zip Code:48076-3406
Practice Address - Country:US
Practice Address - Phone:248-559-5422
Practice Address - Fax:248-559-5426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3964350001Medicare Oscar/Certification