Organization
STATEWIDE MEDICAL SUPPLY LLC
Active
Organization
STATEWIDE MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN GENRICH (DIRECTOR)
(248) 567-2428
Entity
Organization
Contact information
Practice address
28104 ORCHARD LAKE RD STE 140, FARMINGTON HILLS, MI 48334-3759
(248) 567-2428
Mailing address
28104 ORCHARD LAKE RD STE 140, FARMINGTON HILLS, MI 48334-3759
(248) 567-2428
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/19/2021
Last updated
03/19/2021
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