Provider Demographics
NPI:1811452501
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:SOREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-443-4418
Mailing Address - Street 1:27 BROOKLINE
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-1461
Mailing Address - Country:US
Mailing Address - Phone:949-443-4418
Mailing Address - Fax:949-487-4768
Practice Address - Street 1:2863 95TH ST STE 143
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-9006
Practice Address - Country:US
Practice Address - Phone:949-443-4414
Practice Address - Fax:949-487-4768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-06
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL203.001662OtherIL DIV OF PROFESSIONAL REGULATION HOME MEDICAL EQUIPMENT PROVIDER
IL203-001662OtherHMES