| Organization Name: | IRB MEDICAL EQUIPMENT LLC |
| NPI Number: | 1093130866 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KENNETH GERALD FASSE (MANAGER) |
| Mailing Address: | 2333 Biddle Ave Main Lobby Wyandotte |
| State: | MI US |
| Postal Code: | 481924668 |
| Phone Number: | 7342581497 |
| Fax Number: | 7342468799 |
| NPI Enumeration Date: | 03/03/2014 |
| NPI Last Update Date: | 02/17/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |