Macomb Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MACOMB MEDICAL SUPPLY INC

Practice address

36562 Moravian Dr
Clinton Township, MI 48035-1202

Phone

(586) 790-5867

Fax

(586) 790-5916

NPI assigned

Dec 22, 2005

Organization subpart

No

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

Authorized official

Name

Mr. James John Novak Jr.

Title

President

Phone

(586) 790-5867

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346226172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36562 MORAVIAN DR",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480351202",
            "telephone_number": "586-790-5867",
            "fax_number": "586-790-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36562 MORAVIAN DR",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480351202",
            "telephone_number": "586-790-5867",
            "fax_number": "586-790-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACOMB MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NOVAK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-790-5867",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3271301",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "540EO04450",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Macomb Family Services, Inc
• Macomb Family Services, Inc.
• Macomb Gastroenterology PC
• Macomb General and Vascular Surgery, P.L.C.
• Macomb Intermediate School District
• Macomb Oakland Regional Center Inc.
• Macomb Pharmacy and Wellness
• Macomb Regional Dialysis Centers, L.L.C.
• Macomb Therapy Group, PLLC
• Lea Nichole Maddox, D.O.

• Durable Medical Equipment & Medical Supplies in Clinton Township, MI
• Providers in Clinton Township, 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 Aug 22, 2020; 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.