Organization
GREAT LAKES MEDICAL DEVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK HUMPHREY (OWNER)
(810) 701-6418
Entity
Organization
Contact information
Practice address
105 E 2ND ST UNIT H, DAVISON, MI 48423-1467
(810) 447-0135
Mailing address
3196 S IRISH RD, DAVISON, MI 48423-2434
(810) 701-6418
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/19/2024
Last updated
08/27/2025
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