Provider Demographics
NPI:1770057622
Name:ENRICHMENT MEDICAL
Entity type:Organization
Organization Name:ENRICHMENT MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:HELDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-247-1800
Mailing Address - Street 1:734 ALGER ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49507-3593
Mailing Address - Country:US
Mailing Address - Phone:616-247-1800
Mailing Address - Fax:616-247-0460
Practice Address - Street 1:734 ALGER ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49507-3593
Practice Address - Country:US
Practice Address - Phone:616-247-1800
Practice Address - Fax:616-247-0460
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BARA TECHNOLOGIES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies