Provider Demographics
NPI:1063291292
Name:DESTINY MEDICAL AND JANITORIAL SUPPLIES INC.
Entity type:Organization
Organization Name:DESTINY MEDICAL AND JANITORIAL SUPPLIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-320-0919
Mailing Address - Street 1:32455 W 12 MILE RD UNIT 3004
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48333-7142
Mailing Address - Country:US
Mailing Address - Phone:888-320-0919
Mailing Address - Fax:248-702-6193
Practice Address - Street 1:32455 W 12 MILE RD UNIT 3004
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48333-7142
Practice Address - Country:US
Practice Address - Phone:888-320-0919
Practice Address - Fax:248-702-6193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies