Provider Demographics
NPI:1912263062
Name:AMERICAN MATTRESS GALLERY
Entity Type:Organization
Organization Name:AMERICAN MATTRESS GALLERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:2483-749-2000
Mailing Address - Street 1:43235 W 12 MILE RD
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-3016
Mailing Address - Country:US
Mailing Address - Phone:248-349-2000
Mailing Address - Fax:248-349-7255
Practice Address - Street 1:43235 W 12 MILE RD
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-3016
Practice Address - Country:US
Practice Address - Phone:248-349-2000
Practice Address - Fax:248-349-7255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies