Organization Name: | IVY CREEK MEDICAL EQUIPMENT, LLC |
NPI Number: | 1386069755 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL BRUCE (OWNER) |
Mailing Address: | 13 Cambridge Ct Wetumpka |
State: | AL US |
Postal Code: | 360931261 |
Phone Number: | 3345143715 |
Fax Number: | 3345675423 |
NPI Enumeration Date: | 02/21/2014 |
NPI Last Update Date: | 02/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 13290738 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
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 |