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General NPI Number Information
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NPI Number | 1902769029
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Entity Type | Organization
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Legal Business Name | KSS OF SHELBY LLC
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 48875 HAYES RD
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City | SHELBY TWP
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State | MI
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Zip | 48315-4405
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Country | US
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Telephone | 586-532-9602
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Fax | 586-439-5380
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Provider Business Mailing Address
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Address Line | 1773 STAR BATT DR
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-3708
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Country | US
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Telephone | 248-601-9207
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Fax | 248-650-8670
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Authorized Official
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Title or Position | OWNER
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Name | JULIE MARIE MARTEL
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Credential |
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Telephone | 248-408-6004
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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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