Wayne Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

WAYNE MEDICAL SUPPLY

Practice address

26808 Simone St.
Dearborn HTS., MI 48127

Phone

(313) 903-5151

Fax

(313) 908-4510

NPI assigned

Mar 21, 2018

Last updated

Mar 21, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Samar A. Ghosn

Title

Owner/Manager

Phone

(313) 908-4510

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521590400000",
    "number": "1356845689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26808 SIMONE ST.",
            "city": "DEARBORN HTS.",
            "state": "MI",
            "postal_code": "48127",
            "telephone_number": "313-903-5151",
            "fax_number": "313-908-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26808 SIMONE ST.",
            "city": "DEARBORN HTS.",
            "state": "MI",
            "postal_code": "48127",
            "telephone_number": "313-903-5151",
            "fax_number": "313-908-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-21",
        "last_updated": "2018-03-21",
        "status": "A",
        "authorized_official_last_name": "GHOSN",
        "authorized_official_first_name": "SAMAR",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "313-908-4510"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Dearborn HTS, MI
• Providers in Dearborn HTS, 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 Mar 21, 2018; 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.