Organization
SPECTRA MED INC
Active
Other names
SPECTRA MED INC
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL STAYER (PRESIDENT)
(248) 669-5757
Entity
Organization
Contact information
Practice address
3160 HAGGERTY RD STE H, WEST BLOOMFIELD, MI 48323-2001
(248) 669-5757
(248) 669-2090
Mailing address
3160 HAGGERTY RD, STE H, WEST BLOOMFIELD, MI 48323-2000
(248) 669-5757
(248) 669-2090
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010104
MI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140483
PK
—
Enumeration date
08/07/2006
Last updated
02/06/2017
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