Provider Demographics
NPI:1972776185
Name:NIBURG INC
Entity type:Organization
Organization Name:NIBURG INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:NICKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-742-3303
Mailing Address - Street 1:1330 EAST HEMPHILL RD
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48529-1250
Mailing Address - Country:US
Mailing Address - Phone:810-742-3303
Mailing Address - Fax:810-742-1908
Practice Address - Street 1:1330 EAST HEMPHILL RD
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48529-1250
Practice Address - Country:US
Practice Address - Phone:810-742-3303
Practice Address - Fax:810-742-1908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2102153424332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies