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General NPI Number Information
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NPI Number | 1649636036
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Entity Type | Organization
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Legal Business Name | LPM SUPPLY INC
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Dates
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Enumeration Date | 01/14/2016
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Last Update Date | 01/14/2016
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Provider Practice Location Address
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Address Line | 28 N SAGINAW ST SUITE 801
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City | PONTIAC
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State | MI
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Zip | 48342-2134
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Country | US
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Telephone | 248-292-2031
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Fax |
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Provider Business Mailing Address
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Address Line | 20760 DELAWARE ST
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City | SOUTHFIELD
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State | MI
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Zip | 48033-3619
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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 | PRESIDENT
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Name | AMOS AJANI
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Credential |
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Telephone | 248-292-2031
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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 | 04582Q
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License Number State | MI
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