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General NPI Number Information
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NPI Number | 1659934669
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Entity Type | Individual
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Provider Name | JEFFREY PAUL CATES
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Gender | Male
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Dates
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Enumeration Date | 04/16/2019
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Last Update Date | 04/10/2020
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Provider Practice Location Address
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Address Line | 826 W 11 MILE RD
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071-3102
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Country | US
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Telephone | 248-246-1669
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1379
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City | ROYAL OAK
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State | MI
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Zip | 48068-1379
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Country | US
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Telephone | 248-246-1669
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number | 2102185764
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 2102185764
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 2102185764
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | 2102185764
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License Number State | MI
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