Provider Demographics
NPI:1942371893
Name:WILL B SINGLETON
Entity Type:Organization
Organization Name:WILL B SINGLETON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILL
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:SINGLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-922-0211
Mailing Address - Street 1:5555 CONNER STREET
Mailing Address - Street 2:STE 2612
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48213-3494
Mailing Address - Country:US
Mailing Address - Phone:313-922-0211
Mailing Address - Fax:313-922-0888
Practice Address - Street 1:5555 CONNER STREET
Practice Address - Street 2:STE 2612
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48213-3494
Practice Address - Country:US
Practice Address - Phone:313-922-0211
Practice Address - Fax:313-922-0888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
MIA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4838627Medicaid
MI540H227150OtherBLUE CROSS BLUE SHIELD
MI4838627Medicaid
MI5571260001Medicare NSC