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Organization
PRIMESOURCE OF MICHIGAN LLC
Active
Organization
PRIMESOURCE OF MICHIGAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID FLEMING (CEO/PRESIDENT)
(800) 317-0711
Entity
Organization
Contact information
Practice address
2000 TOWN CTR, SUITE 1900, SOUTHFIELD, MI 48075-1135
(800) 317-0711
(877) 821-6402
Mailing address
2100 E LAKE COOK RD, SUITE 1100, BUFFALO GROVE, IL 60089-1999
(800) 317-0711
(877) 821-6402
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
152W00000X
Optometrist
—
—
213E00000X
Podiatrist
Primary
—
—
231H00000X
Audiologist
—
—
Other
Enumeration date
05/29/2013
Last updated
05/29/2013
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