| Organization Name: | PLAGENS MEDICAL SUPPLY CONSULTANTS |
| NPI Number: | 1811386717 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JASON T. WALTERS (SHAREHOLDER/PARTNER) |
| Mailing Address: | 48679 Alpha Dr Suite 100 Wixom |
| State: | MI US |
| Postal Code: | 483933455 |
| Phone Number: | 5175866000 |
| Fax Number: | 5175866001 |
| NPI Enumeration Date: | 01/15/2015 |
| NPI Last Update Date: | 01/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |