Provider Demographics
NPI:1366427981
Name:MED-EQUIP HEALTHCARE, INC.
Entity type:Organization
Organization Name:MED-EQUIP HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-444-1100
Mailing Address - Street 1:629 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-2231
Mailing Address - Country:US
Mailing Address - Phone:781-444-1100
Mailing Address - Fax:781-444-3750
Practice Address - Street 1:629 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-2231
Practice Address - Country:US
Practice Address - Phone:781-444-1100
Practice Address - Fax:781-444-3750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1537385Medicaid
MA376154OtherBLUE CROSS BLUE SHIELD
1110380001Medicare NSC