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General NPI Number Information
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NPI Number | 1578675435
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Entity Type | Organization
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Legal Business Name | METRO MEDICAL HOME SUPPLIERS
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 18121 E 8 MILE RD
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City | EASTPOINTE
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State | MI
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Zip | 48021-3245
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Country | US
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Telephone | 313-729-3298
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Fax |
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Provider Business Mailing Address
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Address Line | 5541 THREE MILE DR
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City | DETROIT
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State | MI
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Zip | 48224-2643
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | YOLANDA NAOMI POWELL
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Credential |
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Telephone | 313-729-3298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number | 4703089853
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License Number State | MI
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