Provider Demographics
NPI:1134189152
Name:NEEL ENTERPRISE LLC
Entity type:Organization
Organization Name:NEEL ENTERPRISE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SUNILKUMAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-682-8070
Mailing Address - Street 1:23800 LAKEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ST CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48082-1157
Mailing Address - Country:US
Mailing Address - Phone:510-682-8070
Mailing Address - Fax:
Practice Address - Street 1:1431 N. LEROY
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430
Practice Address - Country:US
Practice Address - Phone:810-750-6511
Practice Address - Fax:810-750-1460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI540B514320OtherBCBSM
MI4886295Medicaid