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General NPI Number Information
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NPI Number | 1710886072
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Entity Type | Organization
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Legal Business Name | GREAT LAKES MEDICAL DME LLC
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Dates
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Enumeration Date | 11/03/2026
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Last Update Date | 11/03/2026
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Provider Practice Location Address
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Address Line | 200 E BIG BEAVER RD STE 501
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City | TROY
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State | MI
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Zip | 48083-1208
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Country | US
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Telephone | 888-468-5001
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Fax |
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Provider Business Mailing Address
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Address Line | 16350 E ARAPAHOE RD UNIT 162
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City | FOXFIELD
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State | CO
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Zip | 80016-1557
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Country | US
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Telephone | 888-468-5001
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANDREW SANDS
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Credential |
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Telephone | 786-525-2599
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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 |
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