Organization
SPARTAN MEDICAL SUPPLIES LLC
Active
Organization
SPARTAN MEDICAL SUPPLIES LLC
Active
Other names
Spartan Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADAM R GRASSL (MEMBER)
(269) 668-6066
Entity
Organization
Contact information
Practice address
8849 PINE ISLAND COURT SOUTH, MATTAWAN, MI 49071-9570
(269) 668-6066
(269) 924-0675
Mailing address
8849 PINE ISLAND COURT SOUTH, MATTAWAN, MI 49071-9570
(269) 668-6066
(269) 924-0675
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4747470
—
MI
01
—
5404010180
BLUE CROSS BLUE SHIELD
MI
Enumeration date
08/09/2006
Last updated
07/06/2016
Update your record
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