Provider Demographics
NPI:1528830197
Name:DETROIT MEDICAL DEVICES, LLC
Entity type:Organization
Organization Name:DETROIT MEDICAL DEVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:B
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-259-2707
Mailing Address - Street 1:30100 TELEGRAPH RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4515
Mailing Address - Country:US
Mailing Address - Phone:248-716-6220
Mailing Address - Fax:
Practice Address - Street 1:30100 TELEGRAPH RD STE 100
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4515
Practice Address - Country:US
Practice Address - Phone:248-716-6220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-26
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies