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General NPI Number Information
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NPI Number | 1598792491
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Entity Type | Organization
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Legal Business Name | BOK MEDICAL SERVICE
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 211 W GANSON ST STE.110
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City | JACKSON
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State | MI
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Zip | 49201-1262
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Country | US
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Telephone | 517-784-1857
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Fax | 517-784-4138
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Provider Business Mailing Address
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Address Line | 211 WEST GANSON ST, STE.110
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City | JACKSON
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State | MI
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Zip | 49201
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Country | US
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Telephone | 517-784-1857
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Fax | 517-784-4138
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Authorized Official
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Title or Position | OWNER
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Name | MR. BASIL OBASI KALU
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Credential |
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Telephone | 517-784-1857
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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 | MI
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