Healthcare Provider Details

I. General information

NPI: 1851994164
Provider Name (Legal Business Name): WESTLAKE DME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2020
Last Update Date: 08/23/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8231 HIGHLAND PL
MUNSTER IN
46321-1505
US

IV. Provider business mailing address

PO BOX 8664
MICHIGAN CITY IN
46361-8664
US

V. Phone/Fax

Practice location:
  • Phone: 219-210-5725
  • Fax: 217-395-8254
Mailing address:
  • Phone: 219-210-5725
  • Fax: 219-369-4203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224L00000X
TaxonomyPedorthist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ANTWAN LAPREE BURKS
Title or Position: OWNER
Credential:
Phone: 219-210-5725