Provider Demographics
NPI:1821249517
Name:WEST LAKES MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:WEST LAKES MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT AND BOARD MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:C
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-241-5785
Mailing Address - Street 1:5950 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 141
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8216
Mailing Address - Country:US
Mailing Address - Phone:515-875-9900
Mailing Address - Fax:515-875-9899
Practice Address - Street 1:5950 UNIVERSITY AVE
Practice Address - Street 2:SUITE 141
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8216
Practice Address - Country:US
Practice Address - Phone:515-875-9900
Practice Address - Fax:515-875-9899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies