Organization
HAMTRAMCK DURABLE MEDICAL EQUIPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHAMIMA MONNAN (PRESIDENT)
(313) 365-9802
Entity
Organization
Contact information
Practice address
11653 JOSEPH CAMPAU ST, HAMTRAMCK, MI 48212-3839
(313) 365-9802
(313) 365-9804
Mailing address
11653 JOSEPH CAMPAU ST, HAMTRAMCK, MI 48212-3839
(313) 365-9802
(313) 365-9804
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540H225670
BLUE CROSS BLUE SHEILD
MI
Enumeration date
12/01/2006
Last updated
07/21/2022
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