Provider Demographics
NPI:1326170143
Name:MEDICAL ENTERPRISES, INC.
Entity type:Organization
Organization Name:MEDICAL ENTERPRISES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:LUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-453-5204
Mailing Address - Street 1:7484 W MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:PIGEON
Mailing Address - State:MI
Mailing Address - Zip Code:48755-5200
Mailing Address - Country:US
Mailing Address - Phone:989-453-2025
Mailing Address - Fax:989-453-2166
Practice Address - Street 1:7484 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:PIGEON
Practice Address - State:MI
Practice Address - Zip Code:48755-5200
Practice Address - Country:US
Practice Address - Phone:989-453-2025
Practice Address - Fax:989-453-2166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0C265060OtherBLUE CROSS
MI0530800002OtherDMEPOS