MEDICARE: MILK MOVES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1720600463
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILK MOVES LLC

Provider Business Mailing Address
First Line	:	18252 BILTMORE ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48235-3222
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18032 JAMES COUZENS FWY
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48235-2646
Country	:	US
Telephone Number	:	313-358-7085
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JANICA SMITH
Credential	:
Telephone Number	:	313-358-7085

Provider Enumeration Date	:	05/15/2020
Last Update Date	:	05/15/2020

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