Provider Demographics
NPI:1134150964
Name:DURABLE MEDICAL EQUIPMENT SALES & RENTAL COMPANY
Entity type:Organization
Organization Name:DURABLE MEDICAL EQUIPMENT SALES & RENTAL COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-853-0994
Mailing Address - Street 1:100 BLOOMFIELD HILLS PKWY
Mailing Address - Street 2:#195
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-2949
Mailing Address - Country:US
Mailing Address - Phone:248-853-0994
Mailing Address - Fax:248-594-8855
Practice Address - Street 1:100 BLOOMFIELD HILLS PKWY
Practice Address - Street 2:#195
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-2949
Practice Address - Country:US
Practice Address - Phone:248-853-0994
Practice Address - Fax:248-594-8855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4727341Medicaid
MI4727341Medicaid