Red Cedar Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

RED CEDAR MEDICAL SUPPLY LLC

Practice address

50762 Kiawah Trail
Suite B
Mattawan, MI 49071

Phone

(269) 668-9127

Fax

(269) 668-9127

NPI assigned

Jan 29, 2008

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) 668-9127

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1154508596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50762 KIAWAH TRAIL",
            "address_2": "SUITE B",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "49071",
            "telephone_number": "269-668-9127",
            "fax_number": "269-668-9127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50762 KIAWAH TRAIL",
            "address_2": "SUITE B",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "49071",
            "telephone_number": "269-668-9127",
            "fax_number": "269-668-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED CEDAR MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-29",
        "last_updated": "2008-01-29",
        "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": "269-668-9127",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Jan 29, 2008; 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.