Healthcare Provider Details

I. General information

NPI: 1720014715
Provider Name (Legal Business Name): CPL ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 02/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27159 GREENFIELD RD
SOUTHFIELD MI
48076-5135
US

IV. Provider business mailing address

27159 GREENFIELD RD
SOUTHFIELD MI
48076-5135
US

V. Phone/Fax

Practice location:
  • Phone: 248-557-8840
  • Fax: 248-569-9576
Mailing address:
  • Phone: 248-557-8840
  • Fax: 248-569-9576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number5301004562
License Number StateMI

VIII. Authorized Official

Name: MR. PAUL CHARLES KRAUSE
Title or Position: OWNER
Credential: RPH
Phone: 248-557-8840