Michigan Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MICHIGAN MEDICAL SUPPLY INC

Doing business as

Michigan Medical Supply

Practice address

2915 Garfield Rd N
Suite B
Traverse City, MI 49686-4008

Phone

(231) 941-8480

Fax

(231) 941-8508

NPI assigned

Jan 25, 2006

Last updated

Apr 1, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

ROTECH HEALTHCARE INCAs reported in NPPES

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

Authorized official

Name

Mrs. Robin L Menchen

Title

Chief Executive Officer

Phone

(407) 822-4600

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• MICHIGAN MEDICAL SUPPLY Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Part of

Rotech Healthcare Inc

Locations

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1861462590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27968",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270968",
            "telephone_number": "765-448-6685",
            "fax_number": "765-446-4287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 GARFIELD RD N",
            "address_2": "SUITE B",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496864008",
            "telephone_number": "231-941-8480",
            "fax_number": "231-941-8508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN MEDICAL SUPPLY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROTECH HEALTHCARE INC",
        "enumeration_date": "2006-01-25",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "MENCHEN",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "407-822-4600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5098635",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MICHIGAN MEDICAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MICHIGAN MEDICAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Traverse City, MI
• Providers in Traverse City, 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 Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.