State Line Medical, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

STATE LINE MEDICAL, INC

Practice address

13693 Stowell Rd
Dundee, MI 48131-9735

Phone

(734) 529-8888

Fax

(734) 529-5444

NPI assigned

Nov 9, 2006

Last updated

Oct 23, 2007By 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

Mary Williams

Title

Owner

Phone

(734) 529-8888

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193097600000",
    "number": "1710057187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13693 STOWELL RD",
            "city": "DUNDEE",
            "state": "MI",
            "postal_code": "481319735",
            "telephone_number": "734-529-8888",
            "fax_number": "734-529-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13693 STOWELL RD",
            "city": "DUNDEE",
            "state": "MI",
            "postal_code": "481319735",
            "telephone_number": "734-529-8888",
            "fax_number": "734-529-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE LINE MEDICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-10-23",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-529-8888"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; 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.