Organization
IVY CREEK MEDICAL EQUIPMENT, LLC
Active
Organization
IVY CREEK MEDICAL EQUIPMENT, LLC
Active
Other names
Ivy Creek Medical Equipment
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BRUCE (OWNER/DIRECTOR)
(256) 825-0677
Entity
Organization
Contact information
Practice address
201 MARIARDEN RD, DADEVILLE, AL 36853-6244
(256) 825-0677
(256) 827-0803
Mailing address
201 MARIARDEN RD, DADEVILLE, AL 36853-6244
(256) 825-0677
(256) 827-0803
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1307
AL
332B00000X
Durable Medical Equipment & Medical Supplies
715
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009940367
—
AL
01
—
51538455
BCBS OF ALABAMA
AL
Enumeration date
09/20/2006
Last updated
02/18/2014
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