Organization
IVY CREEK MEDICAL EQUIPMENT, LLC
Active
Parent organization
IVY CREEK MEDICAL EQUIPMENT, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
IVY CREEK MEDICAL EQUIPMENT, LLC
Authorized official
MR. MICHAEL BRUCE (OWNER)
(256) 825-0677
Entity
Organization
Contact information
Practice address
13 CAMBRIDGE CT, WETUMPKA, AL 36093-1261
(334) 514-3715
(334) 567-5423
Mailing address
201 MARIARDEN RD, DADEVILLE, AL 36853-6244
(334) 514-3715
(334) 567-5423
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
13290738
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009940367
—
AL
01
—
51538455
BCBS OF ALABAMA
AL
Enumeration date
02/21/2014
Last updated
02/25/2014
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