Provider Demographics
NPI:1497860142
Name:OAKLAND MEDICAL SUPPLIES, INC
Entity Type:Organization
Organization Name:OAKLAND MEDICAL SUPPLIES, INC
Other - Org Name:OAKLAND MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JALAL
Authorized Official - Middle Name:ZIA
Authorized Official - Last Name:DINKHA
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:248-454-7477
Mailing Address - Street 1:43097 WOODWARD AVE
Mailing Address - Street 2:STE.204
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-5041
Mailing Address - Country:US
Mailing Address - Phone:248-454-7477
Mailing Address - Fax:248-671-5009
Practice Address - Street 1:43097 WOODWARD AVE
Practice Address - Street 2:STE.204
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-5041
Practice Address - Country:US
Practice Address - Phone:248-454-7477
Practice Address - Fax:248-671-5009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
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
5641740001Medicare ID - Type Unspecified