Provider Demographics
NPI:1891220752
Name:METRO MEDICAL SUPPLIES ,LLC
Entity Type:Organization
Organization Name:METRO MEDICAL SUPPLIES ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:COA
Authorized Official - Phone:313-404-1405
Mailing Address - Street 1:24681 NORTHWESTERN HWY STE 403-A
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2305
Mailing Address - Country:US
Mailing Address - Phone:313-404-1405
Mailing Address - Fax:248-358-3001
Practice Address - Street 1:24681 NORTHWESTERN HWY STE 403-A
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2305
Practice Address - Country:US
Practice Address - Phone:313-404-1405
Practice Address - Fax:248-358-3001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-27
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIM501349332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies