Healthcare Provider Details

I. General information

NPI: 1609632850
Provider Name (Legal Business Name): A1 MEDICAL SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2024
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26206 W 12 MILE RD STE 204
SOUTHFIELD MI
48034-8500
US

IV. Provider business mailing address

26206 W 12 MILE RD STE 204
SOUTHFIELD MI
48034-8500
US

V. Phone/Fax

Practice location:
  • Phone: 517-366-1447
  • Fax:
Mailing address:
  • Phone: 517-366-1447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State

VIII. Authorized Official

Name: MR. ZACH JOHN
Title or Position: MANGER
Credential:
Phone: 517-366-1447