Provider Demographics
NPI:1386756674
Name:UNIVERSAL DURABLE MEDICAL EQUIPMENT, LLC
Entity type:Organization
Organization Name:UNIVERSAL DURABLE MEDICAL EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUAD
Authorized Official - Middle Name:S
Authorized Official - Last Name:NUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-544-4401
Mailing Address - Street 1:616 OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-4607
Mailing Address - Country:US
Mailing Address - Phone:248-547-9377
Mailing Address - Fax:800-506-0628
Practice Address - Street 1:26555 JOHN R RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-3611
Practice Address - Country:US
Practice Address - Phone:248-544-4401
Practice Address - Fax:800-506-0628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI581332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4892739Medicaid
5691910001Medicare ID - Type Unspecified