Organization
MEDICAL NUTRITIONAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD HANSINGER (CONTROLLER)
(586) 469-0060
Entity
Organization
Contact information
Practice address
44752 MORLEY DR, CLINTON TWP, MI 48036-1357
(586) 469-0060
(586) 469-0111
Mailing address
44752 MORLEY DR, CLINTON TWP, MI 48036-1357
(586) 469-0060
(586) 469-0111
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
ME0113181
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E00360
BLUE CROSS BLUE SHIELD
MI
05
—
1946792
—
MI
Enumeration date
07/28/2005
Last updated
08/22/2020
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