Provider Demographics
NPI:1093284481
Name:AMERICAN DME
Entity type:Organization
Organization Name:AMERICAN DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MERRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-823-3004
Mailing Address - Street 1:2124 MAIN ST STE 160
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-6429
Mailing Address - Country:US
Mailing Address - Phone:714-823-3004
Mailing Address - Fax:
Practice Address - Street 1:2124 MAIN ST STE 160
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-6429
Practice Address - Country:US
Practice Address - Phone:714-823-3004
Practice Address - Fax:800-209-3394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-15
Last Update Date:2020-11-10
Deactivation Date:2020-10-14
Deactivation Code:
Reactivation Date:2020-11-10
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies