Organization
PHOENIX MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LILLIE M NORRIS (OWNER)
(248) 354-5200
Entity
Organization
Contact information
Practice address
23370 COMMERCE DR, FARMINGTON HILLS, MI 48335-2726
(248) 354-5200
(248) 354-9638
Mailing address
23370 COMMERCE DR STE 2, FARMINGTON HILLS, MI 48335-2726
(248) 354-5200
(248) 354-9638
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
06819C
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4315376
—
MI
01
—
540F301900
BLUE CROSS AND BLUE SHIEL
MI
Enumeration date
07/02/2006
Last updated
11/20/2024
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