Organization
WASHTENAW MEDICAL SUPPLIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURIE KAY BUBENHOFER LPN, CFOM (OWNER)
(734) 971-1862
Entity
Organization
Contact information
Practice address
2835 CARPENTER RD, SUITE #1, ANN ARBOR, MI 48108-1172
(734) 971-1862
(734) 971-1553
Mailing address
2835 CARPENTER RD, SUITE #1, ANN ARBOR, MI 48108-1172
(734) 971-1862
(734) 971-1553
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H10409
BLUE CROSS OF MICHIGAN ID
MI
01
—
100137
CARE CHOICES HMO ID #
MI
05
—
4259366
—
MI
Enumeration date
05/23/2006
Last updated
08/30/2007
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