Organization
MOBILE RESPIRATORY&ANCILLARY SERVICE LLC
Active
Organization
MOBILE RESPIRATORY&ANCILLARY SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL JOHNSON (CEO)
(313) 926-1526
Entity
Organization
Contact information
Practice address
13011 W. M C N ICHOLS, DETROIT, MI 48235-4106
(313) 862-2094
(313) 491-0041
Mailing address
13011 W. M C N ICHOLS, DETROIT, MI 48235-4106
(313) 926-1526
(313) 491-0041
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
332B00000X
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4091540 TYPE87
—
MI
01
—
540H219070
BLUE CROSS BLUE SHIELD
MI
Enumeration date
12/27/2007
Last updated
07/08/2008
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