Provider Demographics
NPI:1154829984
Name:TOP PERFORMANCE MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:TOP PERFORMANCE MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-888-0754
Mailing Address - Street 1:PO BOX 470
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48037-0470
Mailing Address - Country:US
Mailing Address - Phone:313-888-0754
Mailing Address - Fax:313-447-2422
Practice Address - Street 1:22815 HILLOCK AVE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48089-5418
Practice Address - Country:US
Practice Address - Phone:313-888-0754
Practice Address - Fax:313-447-2422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-26
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier