Organization
WESTLAKE DME, LLC
Active
Other names
Westlake DME
Organization subpart
No
Provider details
NPI number
Authorized official
ANTWAN LAPREE BURKS (OWNER)
(219) 210-5725
Entity
Organization
Contact information
Practice address
1413 LAFAYETTE ST, MICHIGAN CITY, IN 46360-4524
(219) 210-5725
(219) 369-4203
Mailing address
PO BOX 8664, MICHIGAN CITY, IN 46361-8664
(219) 210-5725
(219) 369-4203
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851994164
—
IN
Enumeration date
11/18/2020
Last updated
02/23/2023
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