Provider Demographics
NPI:1457395741
Name:MEDEQUIP INC
Entity Type:Organization
Organization Name:MEDEQUIP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-737-5466
Mailing Address - Street 1:134 BLISS ST
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-3435
Mailing Address - Country:US
Mailing Address - Phone:413-737-5466
Mailing Address - Fax:413-734-5158
Practice Address - Street 1:134 BLISS ST
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-3435
Practice Address - Country:US
Practice Address - Phone:413-737-5466
Practice Address - Fax:413-734-5158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
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
MA1525689Medicaid
MA191854OtherBLUE CROSS BLUE SHIELD
MA0210330001Medicare ID - Type Unspecified