Provider Demographics
NPI:1891846762
Name:CARMOR,INC
Entity Type:Organization
Organization Name:CARMOR,INC
Other - Org Name:CARMOR, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-402-3700
Mailing Address - Street 1:7060 KENSINGTON RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-8334
Mailing Address - Country:US
Mailing Address - Phone:313-402-3700
Mailing Address - Fax:
Practice Address - Street 1:7060 KENSINGTON RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-8334
Practice Address - Country:US
Practice Address - Phone:313-402-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4620069Medicaid
MI5400710800OtherBLUE CROSS BLUE SHIELD
MI5400710800OtherBLUE CROSS BLUE SHIELD