Organization Name: | IVY CREEK MEDICAL EQUIPMENT, LLC |
NPI Number: | 1962509182 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL BRUCE (OWNER/DIRECTOR) |
Mailing Address: | 201 Mariarden Rd Dadeville |
State: | AL US |
Postal Code: | 368536244 |
Phone Number: | 2568250677 |
Fax Number: | 2568270803 |
NPI Enumeration Date: | 09/20/2006 |
NPI Last Update Date: | 02/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
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 |