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Organization Active NPI

American Durable Medical Equipment and Supplies LLC

  • Durable Medical Equipment & Medical Supplies
  • Saint Clair Shores, MI
National Provider Identifier
1326106030
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
AMERICAN DURABLE MEDICAL EQUIPMENT AND SUPPLIES LLC
Practice address
21901 Harper Ave
Saint Clair Shores, MI 48080-2217
Phone
(586) 863-1840
Fax
(586) 863-1841
NPI assigned
Dec 5, 2006
Last updated
Jan 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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

Authorized official

Name
Mfon Oworoetop
Title
President/Chief Executive Officer
Phone
(586) 863-1840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X MI Primary

Addresses

Primary practice location

21901 Harper Ave
Saint Clair Shores, MI 48080-2217

Mailing address

21901 Harper Ave
Saint Clair Shores, MI 48080-2217
Phone (586) 863-1840

Other identifiers 4

IdentifierTypeStateIssuer
540H21560OtherMIBCBS-MI FED EMPLOYEE PROG
4834100001OtherMIABP ADMINISTRATION
4538970MedicaidMI
540E017240OtherMIBLUE CARE NETWORK

Other names 1

  • American DME & Supplies Other name

National Provider Directory

National Provider Directory

Locations

21901 Harper Ave
Saint Clair Shores, MI 48080
Phone (586) 779-7450

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327449600000",
    "number": "1326106030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21901 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802217",
            "telephone_number": "586-863-1840",
            "fax_number": "586-863-1841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21901 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802217",
            "telephone_number": "586-863-1840",
            "fax_number": "586-863-1841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN DURABLE MEDICAL EQUIPMENT AND SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2012-01-25",
        "status": "A",
        "authorized_official_last_name": "OWOROETOP",
        "authorized_official_first_name": "MFON",
        "authorized_official_title_or_position": "PRESIDENT/CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "15868631840"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-MI FED EMPLOYEE PROG",
            "identifier": "540H21560",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABP ADMINISTRATION",
            "identifier": "4834100001",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4538970",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "540E017240",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American DME & Supplies",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; 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.