Provider Demographics
NPI:1861409906
Name:THOMAS MEDICAL EQUIPMENT GROUP, INC.
Entity type:Organization
Organization Name:THOMAS MEDICAL EQUIPMENT GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:PRUCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-280-4480
Mailing Address - Street 1:PO BOX 1148
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48012-1148
Mailing Address - Country:US
Mailing Address - Phone:877-583-8149
Mailing Address - Fax:248-661-0087
Practice Address - Street 1:21300 GROESBECK HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48089-4920
Practice Address - Country:US
Practice Address - Phone:877-583-8149
Practice Address - Fax:248-661-0087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4744244Medicaid
MI540E022060OtherBLUE CROSS BLUE SHIELD
MI540F327470OtherBLUE CROSS BLUE SHIELD
MI4744244Medicaid