Provider Demographics
NPI:1689834848
Name:NASMAC, LLC
Entity type:Organization
Organization Name:NASMAC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:MACLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-210-4651
Mailing Address - Street 1:3055 KETTERING BLVD STE 219B
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1989
Mailing Address - Country:US
Mailing Address - Phone:586-260-7301
Mailing Address - Fax:
Practice Address - Street 1:20902 MACK AVE STE 203
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE
Practice Address - State:MI
Practice Address - Zip Code:48236-1076
Practice Address - Country:US
Practice Address - Phone:800-346-5837
Practice Address - Fax:586-948-3804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI2024Medicare PIN