Organization
CENTER MEDICAL SUPPLY COMPANY INC
Active
Organization
CENTER MEDICAL SUPPLY COMPANY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID G STEVENS (PRESIDENT)
(269) 381-3252
Entity
Organization
Contact information
Practice address
6224 AVON ST, PORTAGE, MI 49024-2632
(269) 381-3252
(269) 381-1670
Mailing address
6224 AVON ST, PORTAGE, MI 49024-2632
(269) 381-3252
(269) 381-1670
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5026117
—
MI
01
—
540C905570
BLUE CROSS
MI
Enumeration date
12/11/2006
Last updated
04/28/2020
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