Provider Demographics
NPI:1831235282
Name:MAKSUS MEDICAL SUPPLIES INC.
Entity type:Organization
Organization Name:MAKSUS MEDICAL SUPPLIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MUKHEETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-522-9925
Mailing Address - Street 1:35611 CENTRAL CITY PKWY
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-6753
Mailing Address - Country:US
Mailing Address - Phone:734-522-9925
Mailing Address - Fax:734-293-4200
Practice Address - Street 1:35611 CENTRAL CITY PKWY
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-6753
Practice Address - Country:US
Practice Address - Phone:734-522-9925
Practice Address - Fax:734-293-4200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
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
MI4841284Medicaid
MI4841284Medicaid