Medline Medical Supplies LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

MEDLINE MEDICAL SUPPLIES LLC

Practice address

7255 Chase Rd
Dearborn, MI 48126-1301

Phone

(313) 622-7648

NPI assigned

Aug 25, 2021

Last updated

Aug 25, 2021By 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

Fatima Tekko

Title

Owner

Phone

(313) 622-7648

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629849600000",
    "number": "1104593474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7255 CHASE RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261301",
            "telephone_number": "313-622-7648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7255 CHASE RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261301",
            "telephone_number": "313-622-7648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLINE MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A",
        "authorized_official_last_name": "TEKKO",
        "authorized_official_first_name": "FATIMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-622-7648"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "medlinemedsupplies@gmail.com",
            "affiliation": "N",
            "address_1": "7255 Chase Rd",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481261301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Providers in Dearborn, MI by specialty
• Customized Equipment (DME) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.