Provider Demographics
NPI:1003831918
Name:OAKDELL MEDICAL SERVICES
Entity Type:Organization
Organization Name:OAKDELL MEDICAL SERVICES
Other - Org Name:MICHAEL K OBASI
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:KALU
Authorized Official - Last Name:OBASI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-694-8808
Mailing Address - Street 1:2101 AURELIUS RD
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-1380
Mailing Address - Country:US
Mailing Address - Phone:517-694-8808
Mailing Address - Fax:517-694-8868
Practice Address - Street 1:2101 AURELIUS RD
Practice Address - Street 2:SUITE 3A
Practice Address - City:HOLT
Practice Address - State:MI
Practice Address - Zip Code:48842-1380
Practice Address - Country:US
Practice Address - Phone:517-694-8808
Practice Address - Fax:517-694-8868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI120457094OtherTRICARE NORTH
MI4962950Medicaid
TXTXW 0013701OtherBEDDING LICENSE
MI54-C3-1417-0OtherBCBS BLUE CARE NETWORK
MI1003831918OtherNPI
TXTXW 0013701OtherBEDDING LICENSE
MI120457094OtherTRICARE NORTH