Provider Demographics
NPI:1205054376
Name:METRO DETROIT MEDICAL EQUIPMENT,INC
Entity type:Organization
Organization Name:METRO DETROIT MEDICAL EQUIPMENT,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-475-9898
Mailing Address - Street 1:2142 PONTIAC RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-2409
Mailing Address - Country:US
Mailing Address - Phone:248-475-9898
Mailing Address - Fax:248-475-1120
Practice Address - Street 1:2142 PONTIAC RD
Practice Address - Street 2:SUITE 201
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-2409
Practice Address - Country:US
Practice Address - Phone:248-475-9898
Practice Address - Fax:248-475-1120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1290700001Medicare ID - Type UnspecifiedMEDICARE ID NUMBER