Active NPI
Ghaleb Mroue
- Durable Medical Equipment & Medical Supplies
- Dearborn, MI
National Provider Identifier
1174084941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Practice address
- 6436 Steadman St
Dearborn, MI 48126-2057 - Phone
- (313) 377-2400
- Fax
- (248) 809-6865
- NPI assigned
- Mar 26, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
6436 Steadman St
Dearborn, MI 48126-2057
Mailing address
25354 Evergreen Rd Ste 103
Southfield, MI 48075-1776
Phone (313) 377-2400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 802300418 | Other | MI | MEDICAL EQUIMENT |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | dearborn | Direct | |
| Other URL | SOUTHFIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559520000000",
"number": "1174084941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25354 EVERGREEN RD STE 103",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480751776",
"telephone_number": "313-377-2400",
"fax_number": "248-809-6865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6436 STEADMAN ST",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481262057",
"telephone_number": "313-377-2400",
"fax_number": "248-809-6865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MROUE",
"first_name": "GHALEB",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-26",
"last_updated": "2019-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL EQUIMENT",
"identifier": "802300418",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "dearborn",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "6436 Steadman St",
"city": "Dearborn",
"state": "MI",
"country_code": "US",
"postal_code": "481262057",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "SOUTHFIELD",
"affiliation": "N",
"address_1": "25354 Evergreen Rd",
"city": "Southfield",
"state": "MI",
"country_code": "US",
"postal_code": "480751776",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.