Organization
ACTIVE HOME MEDICAL SUPPLY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY MARIE FIKE (CEO)
(810) 667-6962
Entity
Organization
Contact information
Practice address
655 MCCORMICK DR STE A, LAPEER, MI 48446-3922
(810) 667-6962
(810) 667-9204
Mailing address
655 MCCORMICK DR STE A, LAPEER, MI 48446-3922
(810) 667-6962
(810) 667-9204
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BN1400X
Nursing Facility Supplies (DME)
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540D41147
BLUE CROSS BLUE SHIELD
MI
05
—
872570656
—
MI
Enumeration date
12/27/2006
Last updated
04/17/2026
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