Mystic Medical Equipment Incorporated

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MYSTIC MEDICAL EQUIPMENT INCORPORATED

Practice address

23660 Research Dr
Farmington Hills, MI 48335-2643

Phone

(248) 476-8811

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Paul F Wenson

Title

Owner Ceo

Phone

(248) 476-8811

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

• Binson'S Hospital Supplies, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Livonia, MI
  • NPI 1427325653

  Member Of

  NPD member
• Northwood Inc

  • Durable Medical Equipment & Medical Supplies
  • Madison Heights, MI
  • NPI 1851337604

  Member Of

  NPD member
• Florida Home Medical Supply Inc

  • Oxygen Equipment & Supplies (DME)
  • Lady Lake, FL
  • NPI 1578724118

  Member Of

  NPD member

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313366400000",
    "number": "1518098276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23660 RESEARCH DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483352643",
            "telephone_number": "248-476-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23660 RESEARCH DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483352643",
            "telephone_number": "248-476-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYSTIC MEDICAL EQUIPMENT INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2011-08-15",
        "status": "A",
        "authorized_official_last_name": "WENSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER CEO",
        "authorized_official_telephone_number": "248-476-8811",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "3025219",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Johnnelle Myrick
• Joseph Myrick
• La'Nahya Myrick
• Tasha Myrick
• Heather Myser
• Reena E Naami, MS, BCBA
• Salmah Naamou
• Jonathan Naar
• Umi Nabacwa
• Nicole Naber

• Durable Medical Equipment & Medical Supplies in Farmington Hills, MI
• Providers in Farmington Hills, 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 15, 2011; 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.