Provider Demographics
NPI:1669870861
Name:PREMIER DURABLE MEDICAL EQUIPMENT LLC
Entity type:Organization
Organization Name:PREMIER DURABLE MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NISSRINE
Authorized Official - Middle Name:I
Authorized Official - Last Name:MAKKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-663-0121
Mailing Address - Street 1:26715 KINGSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-3316
Mailing Address - Country:US
Mailing Address - Phone:313-663-0121
Mailing Address - Fax:
Practice Address - Street 1:26715 KINGSWOOD DR
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-3316
Practice Address - Country:US
Practice Address - Phone:313-663-0121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-21
Last Update Date:2014-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies