Organization
MYSTIC MEDICAL EQUIPMENT INCORPORATED
Active
Organization
MYSTIC MEDICAL EQUIPMENT INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL F WENSON (OWNER CEO)
(248) 476-8811
Entity
Organization
Contact information
Practice address
23660 RESEARCH DR, FARMINGTON HILLS, MI 48335-2643
(248) 476-8811
Mailing address
23660 RESEARCH DR, FARMINGTON HILLS, MI 48335-2643
(248) 476-8811
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3025219
—
MI
Enumeration date
03/07/2007
Last updated
08/15/2011
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