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Michigan Street Optical
Durable Medical Equipment & Medical Supplies in Grand Rapids, Michigan
NPI 1043350689

Michigan Street Optical is a Durable Medical Equipment & Medical Supplies based in Portage, MI. Michigan Street Optical practices in Grand Rapids, MI. The NPI Number for Michigan Street Optical is 1043350689 and holds a License No. 4301030073 (Michigan).

The current practice location address for Michigan Street Optical is 426 Michigan St Ne, Grand Rapids, MI and can be reached out via phone at 616-459-1844 and via fax at 616-459-3716.

Location: 426 Michigan St Ne, Grand Rapids, MI, 49081-2588
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1043350689
Provider Name
Michigan Street Optical
Credential
Provider Entity Type
Organization
Address
426 Michigan St Ne, Grand Rapids, MI, 49081-2588
Phone Number
616-459-1844
Fax Number
616-459-3716
Provider Enumeration Date
02/06/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
540D116620 01 MI BLUE CROSS BLUE SHEILD
institution
Provider Business Practice Location Address Details
Address
426 Michigan St Ne
City
Grand Rapids
State
Michigan
Zip
49503-5609
Phone Number
616-459-1844
Fax Number
616-459-3716
person
Provider Business Mailing Address Details
Address
426 Michigan St Ne
City
Grand Rapids
State
Michigan
Zip
49503-5609
Phone Number
616-459-1844
Fax Number
616-459-3716
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
332B00000X
License No.
4301030073 (Michigan)
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
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