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Organization
LAKESIDE OXYGEN SUPPLY, INC.
Active
Organization
LAKESIDE OXYGEN SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. COLLEEN MARIE NEVEUX (PRESIDENT)
(313) 303-0135
Entity
Organization
Contact information
Practice address
19818 MACK AVE, GROSSE POINTE WOODS, MI 48236-2506
(313) 647-0227
(313) 647-0228
Mailing address
19818 MACK AVE, GROSSE POINTE WOODS, MI 48236-2506
(313) 647-0227
(313) 647-0228
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
10/03/2007
Last updated
11/27/2007
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