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Organization

BABY BOOMER MEDICAL SUPPLIES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. OKEZIE WACHUKU (CEO)
(586) 698-2071
Entity
Organization

Contact information

Practice address
3058 METRO PKWY, SUITE 110, STERLING HEIGHTS, MI 48310-3671
(586) 698-2071
(586) 698-2074
Mailing address
3058 METRO PKWY, SUITE 110, STERLING HEIGHTS, MI 48310-3671
(586) 698-2071
(586) 698-2074

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
332BX2000X
Oxygen Equipment & Supplies (DME)

Other

Enumeration date
06/09/2010
Last updated
06/09/2010
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