Provider Demographics
NPI:1417192675
Name:ELK MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:ELK MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SNAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-663-4105
Mailing Address - Street 1:15511 REECK RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-2651
Mailing Address - Country:US
Mailing Address - Phone:734-283-6408
Mailing Address - Fax:
Practice Address - Street 1:20700 CIVIC CENTER DR STE 170
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-4148
Practice Address - Country:US
Practice Address - Phone:248-663-4105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-02
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0844900001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0844900001Medicare NSC