Organization Active NPI

Michigan Rehabilitation Specialists of Fowlerville, LLC

  • Durable Medical Equipment & Medical Supplies
  • Canton, MI
National Provider Identifier
1003433905
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MICHIGAN REHABILITATION SPECIALISTS OF FOWLERVILLE, LLC
Practice address
42955 Ford Rd
Canton, MI 48187-3377
Phone
(734) 981-2100
NPI assigned
Jun 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Wade A Meyer
Title
VP Chief Compliance Officer
Phone
(630) 296-2222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

42955 Ford Rd
Canton, MI 48187-3377

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1003433905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42955 FORD RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873377",
            "telephone_number": "734-981-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN REHABILITATION SPECIALISTS OF FOWLERVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-26",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "WADE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "630-296-2222"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.