Organization
LAKESHORE MEDICAL TRANSPORT AND SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONTE ROBERTS (PRESIDENT)
(313) 329-8125
Entity
Organization
Contact information
Practice address
11450 MINDEN ST, DETROIT, MI 48205-3763
(313) 437-3841
Mailing address
11450 MINDEN ST, DETROIT, MI 48205-3763
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
12/04/2017
Last updated
07/07/2021
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