Organization
COMMUNITY MEDICAL EQUIPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J MAZUREK (GENERAL MANAGER)
(313) 359-1963
Entity
Organization
Contact information
Practice address
21505 VAN BORN RD, TAYLOR, MI 48180-1337
(313) 359-1963
(313) 359-1966
Mailing address
21505 VAN BORN RD, SUITE 102, TAYLOR, MI 48180-1337
(313) 359-1963
(313) 359-1966
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
A ME 0155462
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0 H2 1732
BCBS OF MI #
MI
05
—
4627435
—
MI
Enumeration date
11/28/2005
Last updated
05/01/2008
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