Provider Demographics
NPI:1881900306
Name:SPECIALTY MEDICAL EQUIPMENT INC.
Entity type:Organization
Organization Name:SPECIALTY MEDICAL EQUIPMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOBLICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-622-3023
Mailing Address - Street 1:52040 VAN DYKE AVE
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-3526
Mailing Address - Country:US
Mailing Address - Phone:877-622-3023
Mailing Address - Fax:
Practice Address - Street 1:52040 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-3526
Practice Address - Country:US
Practice Address - Phone:877-622-3023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-21
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6767710001Medicare NSC