1548933690 NPI number — REDEMPTIVE MEDICAL EQUIPMENT ,LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548933690 NPI number — REDEMPTIVE MEDICAL EQUIPMENT ,LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REDEMPTIVE MEDICAL EQUIPMENT ,LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548933690
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/26/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30550 GRATIOT AVE UNIT 247
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROSEVILLE
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48066-6710
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
586-498-7900
Provider Business Mailing Address Fax Number:
877-218-4462

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10970 S CLEVELAND AVE STE 601
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT MYERS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33907-2346
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-498-7903
Provider Business Practice Location Address Fax Number:
877-218-4462
Provider Enumeration Date:
07/26/2021

Additional Information

Authorized Official

Authorized Official Last Name:
DUNN
Authorized Official First Name:
ANGIE
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING
Authorized Official Telephone Number:
586-498-7900

Provider Taxonomy Codes

  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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