Organization
WESTSIDE MEDICAL DEVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY DIMAYA (OWNER)
(734) 812-1164
Entity
Organization
Contact information
Practice address
25500 MEADOWBROOK RD STE 275C, NOVI, MI 48375-1878
(734) 812-1164
Mailing address
25500 MEADOWBROOK RD STE 275C, NOVI, MI 48375-1878
(734) 812-1164
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
802975418
SOM
MI
Enumeration date
01/30/2023
Last updated
01/30/2023
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