Provider Demographics
NPI:1316378839
Name:WEST SHORE MEDICAL
Entity Type:Organization
Organization Name:WEST SHORE MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSEZELIA
Authorized Official - Middle Name:F
Authorized Official - Last Name:SCHLEINZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:231-755-0637
Mailing Address - Street 1:955 W BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49441-3521
Mailing Address - Country:US
Mailing Address - Phone:231-755-0637
Mailing Address - Fax:231-755-6208
Practice Address - Street 1:955 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49441-3521
Practice Address - Country:US
Practice Address - Phone:231-755-0637
Practice Address - Fax:231-755-6208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703084848251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health