Spartan Medical Supplies LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SPARTAN MEDICAL SUPPLIES LLC

Doing business as

Spartan Medical Supply

Practice address

8849 Pine Island Court South
Mattawan, MI 49071-9570

Phone

(269) 668-6066

Fax

(269) 924-0675

NPI assigned

Aug 9, 2006

Last updated

Jul 6, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Adam R Grassl

Title

Member

Phone

(269) 668-6066

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Spartan Medical Supply Doing business as

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467763200000",
    "number": "1073523163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8849 PINE ISLAND COURT SOUTH",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490719570",
            "telephone_number": "269-668-6066",
            "fax_number": "269-924-0675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8849 PINE ISLAND COURT SOUTH",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490719570",
            "telephone_number": "269-668-6066",
            "fax_number": "269-924-0675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARTAN MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2016-07-06",
        "status": "A",
        "authorized_official_last_name": "GRASSL",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "269-668-6066",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4747470",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5404010180",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spartan Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Teresa M Seim, O.D.
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• Britney L Sides
• Katherine Soens, OTR/L
• Nicole Straub
• Nicolas Talentino, ATC
• Kathryn Faith Taylor, M.A.L.P.C
• Teagen Ada Anne Tenbrink
• Andrew John Tironi, PHARMD

• Durable Medical Equipment & Medical Supplies in Mattawan, MI
• Providers in Mattawan, MI by specialty
• Durable Medical Equipment & Medical Supplies in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; 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.