Provider Demographics
NPI:1720014715
Name:CPL ENTERPRISES INC
Entity Type:Organization
Organization Name:CPL ENTERPRISES INC
Other - Org Name:THE MEDICINE CABINET
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:248-557-8840
Mailing Address - Street 1:27159 GREENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-5135
Mailing Address - Country:US
Mailing Address - Phone:248-557-8840
Mailing Address - Fax:248-569-9576
Practice Address - Street 1:27159 GREENFIELD RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-5135
Practice Address - Country:US
Practice Address - Phone:248-557-8840
Practice Address - Fax:248-569-9576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301004562332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4095272Medicaid
MI540F30741OtherBCBS DME PROVIDER NUMBER
MI4095272Medicaid