Michigan Medical PC
Organization Active NPI Durable Medical Equipment & Medical Supplies · Grand Rapids, MI
NPI 1164680294 · NPPES record last updated May 27, 2008
Key facts
- NPI
- 1164680294
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- License
- 5101016694 (MI)
- Legal business name
- MICHIGAN MEDICAL PC
- Practice address
- 3322 E Beltline CT NE
Grand Rapids, MI 49525-9480 - Phone
- (616) 456-9104
- NPI assigned
- May 27, 2008
- Organization subpart
- No
Authorized official
- Name
- Scott Harring, CFO
- Title
- Cfo
- Phone
- (616) 974-4470
Corporate family (same tax ID) 22
National Provider Directory
- Tax ID family
- Michigan Med Spec PC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 5101016694 | MI | Yes |
Addresses
Primary practice location
3322 E Beltline CT NE
Grand Rapids, MI 49525-9480
Mailing address
4085 Burton St SE
Suite 200
Grand Rapids, MI 49546-2444
NPI Registry JSON
{
"created_epoch": "1211846400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1211846400000",
"number": "1164680294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4085 BURTON ST SE",
"address_2": "SUITE 200",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495462444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3322 E BELTLINE CT NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495259480",
"telephone_number": "616-456-9104"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MICHIGAN MEDICAL PC",
"organizational_subpart": "NO",
"enumeration_date": "2008-05-27",
"last_updated": "2008-05-27",
"status": "A",
"authorized_official_last_name": "HARRING",
"authorized_official_first_name": "SCOTT",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "616-974-4470",
"authorized_official_credential": "CFO"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "MI",
"license": "5101016694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
- Michigan Medical Patient Care
- Michigan Medical Patient Care
- Michigan Medical Patient Care
- Michigan Medical Patient Care
- Michigan Medical Patient Care
- Michigan Medical PC
- Michigan Medical PC
- Michigan Medical PC
- Michigan Medical, PC.
- Michigan Nemt LLC
All providers in Grand Rapids, 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 May 27, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.