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Organization
DIRECT MEDICAL EQUIPMENT
Active
Organization
DIRECT MEDICAL EQUIPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY W POLLICELLA (PRESIDENT)
(734) 451-1414
Entity
Organization
Contact information
Practice address
9282 GENERAL DR, SUITE # 150, PLYMOUTH, MI 48170-4694
(734) 451-1414
(734) 451-0404
Mailing address
9282 GENERAL DR, SUITE # 150, PLYMOUTH, MI 48170-4694
(734) 451-1414
(734) 451-0404
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
MI
332BC3200X
Customized Equipment (DME)
—
MI
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4479118
—
MI
Enumeration date
02/20/2007
Last updated
09/11/2025
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