Organization Name: | INTEGRATED DME LLC |
NPI Number: | 1871812032 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DOUGLAS MACKEY (OWNER) |
Mailing Address: | 2818 Eagle Valley Dr Woodbury |
State: | MN US |
Postal Code: | 551294263 |
Phone Number: | 9528075389 |
Fax Number: | |
NPI Enumeration Date: | 05/26/2010 |
NPI Last Update Date: | 05/26/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 3756181-3 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
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 |