Provider Demographics
NPI:1861778540
Name:RUSHTON, ALAN
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:
Last Name:RUSHTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3115 W BEAR LAKE RD
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-9827
Mailing Address - Country:US
Mailing Address - Phone:517-610-5110
Mailing Address - Fax:
Practice Address - Street 1:3115 W BEAR LAKE RD
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-9827
Practice Address - Country:US
Practice Address - Phone:517-610-5110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1861778540OtherDURABLE MEDICAL EQUIPMENT & MEDICAL SUPPLIES