Provider Demographics
NPI:1437256088
Name:METRO MEDICAL HOME SUPPLIERS
Entity Type:Organization
Organization Name:METRO MEDICAL HOME SUPPLIERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:N
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:586-744-5392
Mailing Address - Street 1:5541 THREE MILE DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48224-2643
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5541 THREE MILE DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48224-2643
Practice Address - Country:US
Practice Address - Phone:586-744-5392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703089853332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies