Healthcare Provider Details

I. General information

NPI: 1326552779
Provider Name (Legal Business Name): 161 PRIVATE HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2017
Last Update Date: 11/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6041 LYTHAM CT
HUDSONVILLE MI
49426-8990
US

IV. Provider business mailing address

PO BOX 581
HUDSONVILLE MI
49426-0581
US

V. Phone/Fax

Practice location:
  • Phone: 616-422-5494
  • Fax:
Mailing address:
  • Phone:
  • 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: RICHARD BRUMMEL
Title or Position: COO
Credential:
Phone: 616-422-5494