Provider Demographics
NPI:1902954183
Name:HEALTH CARE MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:HEALTH CARE MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:OMAR
Authorized Official - Last Name:MALIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-552-9707
Mailing Address - Street 1:15565 NORTHLAND DR W
Mailing Address - Street 2:STE 702 W
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5305
Mailing Address - Country:US
Mailing Address - Phone:248-552-9707
Mailing Address - Fax:248-552-9706
Practice Address - Street 1:15565 NORTHLAND DR W
Practice Address - Street 2:STE 702 W
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5303
Practice Address - Country:US
Practice Address - Phone:248-552-9707
Practice Address - Fax:248-552-9706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5713200001Medicare NSC