Provider Demographics
NPI:1912092073
Name:MICHIGAN MEDICAL EQUIPMENT,INC.
Entity Type:Organization
Organization Name:MICHIGAN MEDICAL EQUIPMENT,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TERWILLIGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-522-8531
Mailing Address - Street 1:11906 FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1724
Mailing Address - Country:US
Mailing Address - Phone:734-522-8531
Mailing Address - Fax:734-522-6846
Practice Address - Street 1:11918 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1724
Practice Address - Country:US
Practice Address - Phone:734-522-8531
Practice Address - Fax:734-522-6846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2639197Medicaid
MI2639197Medicaid