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General NPI Number Information
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NPI Number | 1205114014
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Entity Type | Organization
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Legal Business Name | LAKE ERIE MEDICAL & SURGICAL SUPPLY, INC
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Dates
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Enumeration Date | 07/27/2011
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Last Update Date | 07/27/2011
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Provider Practice Location Address
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Address Line | 7560 LEWIS AVE
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City | TEMPERANCE
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State | MI
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Zip | 48182-9539
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Country | US
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Telephone | 734-847-3847
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Fax | 419-724-1052
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Provider Business Mailing Address
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Address Line | 7560 LEWIS AVE
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City | TEMPERANCE
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State | MI
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Zip | 48182-9539
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Country | US
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Telephone | 734-847-3847
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Fax | 419-724-1052
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Authorized Official
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Title or Position | TREASURER
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Name | MRS. JEANNIE MARIE SIEREN
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Credential |
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Telephone | 734-847-2710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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