Provider Demographics
NPI:1013904820
Name:REMER SURGICAL SUPPLY LLC
Entity Type:Organization
Organization Name:REMER SURGICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:DEJONCKHEERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-498-6200
Mailing Address - Street 1:21339 GRATIOT AVE
Mailing Address - Street 2:
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-2831
Mailing Address - Country:US
Mailing Address - Phone:586-498-6200
Mailing Address - Fax:586-498-6204
Practice Address - Street 1:21339 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-2831
Practice Address - Country:US
Practice Address - Phone:586-498-6200
Practice Address - Fax:586-498-6204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5068879Medicaid
MI5068879Medicaid