Organization
INDEPENDENT MEDICAL SUPPLY COMANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY LYNN WANSHON (OWNER)
(734) 756-6872
Entity
Organization
Contact information
Practice address
14486 OXFORD, PLYMOUTH, MI 48170-2674
(734) 756-6872
(734) 404-6478
Mailing address
14486 OXFORD, PLYMOUTH, MI 48170-2674
(734) 756-6872
(734) 404-6478
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/06/2010
Last updated
11/06/2010
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