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General NPI Number Information
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NPI Number | 1902209810
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Entity Type | Organization
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Legal Business Name | CAMPAU MEDICAL SUPPLIES LLC
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Dates
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Enumeration Date | 10/06/2014
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Last Update Date | 10/06/2014
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Provider Practice Location Address
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Address Line | 8638 JOSEPH CAMPAU ST
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City | HAMTRAMCK
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State | MI
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Zip | 48212-3717
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Country | US
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Telephone | 313-632-8761
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Fax |
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Provider Business Mailing Address
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Address Line | 8638 JOSEPH CAMPAU ST
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City | HAMTRAMCK
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State | MI
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Zip | 48212-3717
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Country | US
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Telephone | 313-632-8761
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ABDULKALK KAID PADY
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Credential |
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Telephone | 313-632-8761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number | E5183E
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License Number State | MI
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