Provider Demographics
NPI:1366505679
Name:NOVI ARCH SUPPORTS INC
Entity Type:Organization
Organization Name:NOVI ARCH SUPPORTS INC
Other - Org Name:NOVI FOOT FOCUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:YALDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-449-5300
Mailing Address - Street 1:PO BOX 250004
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48325-0004
Mailing Address - Country:US
Mailing Address - Phone:248-449-5300
Mailing Address - Fax:248-449-7307
Practice Address - Street 1:43043 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-1733
Practice Address - Country:US
Practice Address - Phone:248-449-5300
Practice Address - Fax:248-449-7307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5851090001Medicare NSC