Djo, LLC
Organization Active NPI Durable Medical Equipment & Medical Supplies · Holt, MI
NPI 1003632084 · NPPES record last updated Dec 5, 2025
Key facts
- NPI
- 1003632084
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- Legal business name
- DJO, LLC
- Practice address
- 2373 Cedar Park Dr Ste 100
Holt, MI 48842-3102 - Phone
- (517) 908-0280
- NPI assigned
- Nov 25, 2024
- Organization subpart
- Yes
- Parent organization (as reported)
- DJO, LLC
Authorized official
- Name
- Mr. Andres Moreno III
- Title
- President
- Phone
- (800) 321-9549
Parent organization (reported in NPPES) 1
Other NPIs with the same Medicare PAC ID 6
Corporate family (same tax ID) 8
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Djo, LLC |
Heat & Cold Applications|Osteogenesis Stimulators|Canes and/or Crutches|Walkers|Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20260430004450 | MI | DME Supplier - Medical Supply Company |
1456472703 | Practice locations: Holt, MI |
National Provider Directory
- Tax ID family
- Djo LLC
- Part of
- Djo LLC
Locations
2373 Cedar Park Dr
Ste 100
Holt, MI 48842
Phone (517) 908-0280
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Yes | ||
| Customized Equipment (DME) | 332BC3200X | |||
| Prosthetic/Orthotic Supplier | 335E00000X |
Addresses
Primary practice location
2373 Cedar Park Dr Ste 100
Holt, MI 48842-3102
Mailing address
2900 Lake Vista Dr Ste 200
Lewisville, TX 75067-3889
Phone (704) 749-6291
Other providers in Holt, MI
- Dengs Acupuncture LLC
- Ryan Deubel
- Justin Michael Dew
- Dion Wellness PC
- Andrew Thomas Dion
- John Phillip Dohm
- Anna Donaldson
- Dr. Linda Fisher-Williams, D.O.
- Brandi D Drent
- Miles Drobish
All providers in Holt, MI · Durable Medical Equipment & Medical Supplies in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.