Provider Demographics
NPI:1770699373
Name:MEDICUS DURABLE MEDICAL EQUIP. CO.
Entity type:Organization
Organization Name:MEDICUS DURABLE MEDICAL EQUIP. CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-366-8996
Mailing Address - Street 1:1139 LATHROP AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305-1452
Mailing Address - Country:US
Mailing Address - Phone:708-366-8996
Mailing Address - Fax:798-366-1478
Practice Address - Street 1:1139 LATHROP AVE
Practice Address - Street 2:
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305-1452
Practice Address - Country:US
Practice Address - Phone:708-366-8996
Practice Address - Fax:798-366-1478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies