Healthcare Provider Details

I. General information

NPI: 1528202645
Provider Name (Legal Business Name): ENJOY LIFE MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2009
Last Update Date: 04/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 N MAPLE AVE
ROYAL OAK MI
48067-2254
US

IV. Provider business mailing address

207 N MAPLE AVE
ROYAL OAK MI
48067-2254
US

V. Phone/Fax

Practice location:
  • Phone: 248-255-1828
  • Fax:
Mailing address:
  • Phone: 248-255-1828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ROBERT WELCH
Title or Position: PRINCIPAL
Credential:
Phone: 248-255-1828