Provider Demographics
NPI:1225185085
Name:THOMAS MEDICAL SALES LLC
Entity Type:Organization
Organization Name:THOMAS MEDICAL SALES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:KIEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-647-4604
Mailing Address - Street 1:5440 HAMMERSMITH DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-1451
Mailing Address - Country:US
Mailing Address - Phone:888-647-4604
Mailing Address - Fax:248-661-0087
Practice Address - Street 1:5440 HAMMERSMITH DR
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-1451
Practice Address - Country:US
Practice Address - Phone:888-647-4604
Practice Address - Fax:248-661-0087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4179532Medicaid
MI1305280001Medicare ID - Type Unspecified