Provider Demographics
NPI:1598830622
Name:NEOPEDICS PLUS INC
Entity Type:Organization
Organization Name:NEOPEDICS PLUS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:248-650-3080
Mailing Address - Street 1:1790 S LIVERNOIS RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-3375
Mailing Address - Country:US
Mailing Address - Phone:248-650-3080
Mailing Address - Fax:
Practice Address - Street 1:1790 S LIVERNOIS RD
Practice Address - Street 2:SUITE 203
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-3375
Practice Address - Country:US
Practice Address - Phone:248-650-3080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
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
540F30681OtherBCBSM
MI1578650Medicaid
540F30681OtherBCBSM