Organization Name: | MATTHEW THAYER |
NPI Number: | 1093885329 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MATTHEW THAYER (OWNER) |
Mailing Address: | 3305 Remembrance Rd Nw Grand Rapids |
State: | MI US |
Postal Code: | 495347729 |
Phone Number: | 6168266231 |
Fax Number: | 6167914060 |
NPI Enumeration Date: | 11/08/2006 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | F========= |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |