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General NPI Number Information
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NPI Number | 1659326270
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Entity Type | Organization
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Legal Business Name | LAKELAND MEDICAL EQUIPMENT LLC
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 211 HILLTOP RD SUITE S
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-2300
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Country | US
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Telephone | 269-983-0202
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Fax | 269-982-0224
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Provider Business Mailing Address
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Address Line | 211 HILLTOP RD SUITE S
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-2300
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Country | US
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Telephone | 269-983-0202
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Fax | 269-982-0224
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. DENNIS MACK
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Credential |
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Telephone | 269-983-8399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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