Organization
JOHNSONS MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KRYSTAL JOHNSON (PRESIDENT)
(248) 758-9813
Entity
Organization
Contact information
Practice address
31 OAKLAND AVE, SUITE 1B, PONTIAC, MI 48342-2019
(248) 758-9813
Mailing address
31 OAKLAND AVE, SUITE 1B, PONTIAC, MI 48342-2019
(248) 758-9813
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4853463
—
MI
01
—
540F332870
BLUE CROSS BLUE SHIELD
MI
Enumeration date
03/19/2007
Last updated
05/29/2008
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