Healthcare Provider Details

I. General information

NPI: 1871207068
Provider Name (Legal Business Name): GEDRAITIS INDUSTRIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2023
Last Update Date: 01/11/2023
Certification Date: 12/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13024 SCOTT RD
DAVISBURG MI
48350-2922
US

IV. Provider business mailing address

13024 SCOTT RD
DAVISBURG MI
48350-2922
US

V. Phone/Fax

Practice location:
  • Phone: 248-369-5847
  • Fax:
Mailing address:
  • Phone: 248-369-5847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DAVID JOHN GEDRAITIS
Title or Position: CEO
Credential:
Phone: 248-369-5847