Healthcare Provider Details

I. General information

NPI: 1669342788
Provider Name (Legal Business Name): CLAUDETTE TOUSSAINT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3017 PLAINFIELD AVE NE
GRAND RAPIDS MI
49505-3258
US

IV. Provider business mailing address

3017 PLAINFIELD AVE NE
GRAND RAPIDS MI
49505-3258
US

V. Phone/Fax

Practice location:
  • Phone: 517-526-7600
  • Fax:
Mailing address:
  • Phone: 517-526-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberD255119001002
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberD255119001002
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberD255119001002
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: