Provider Demographics
NPI:1316995640
Name:REFLECTION MEDICAL, INC.
Entity type:Organization
Organization Name:REFLECTION MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:A
Authorized Official - Last Name:LILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-850-0777
Mailing Address - Street 1:3200 W TEMPERANCE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:TEMPERANCE
Mailing Address - State:MI
Mailing Address - Zip Code:48182-2415
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3200 W TEMPERANCE RD
Practice Address - Street 2:SUITE B
Practice Address - City:TEMPERANCE
Practice Address - State:MI
Practice Address - Zip Code:48182-2415
Practice Address - Country:US
Practice Address - Phone:734-850-0777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2303877Medicaid
OHHMEL.11129OtherRESPIRATORY CARE BOARD
MI4483630Medicaid
OH2303877Medicaid
MI4483630Medicaid