Provider Demographics
NPI:1588162168
Name:VALERIE BZEIH IATRICS MEDICAL SUPPLIES AND EQUIPMENT
Entity type:Organization
Organization Name:VALERIE BZEIH IATRICS MEDICAL SUPPLIES AND EQUIPMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BZEIH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-436-5324
Mailing Address - Street 1:7243 REUTER ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1545
Mailing Address - Country:US
Mailing Address - Phone:313-285-4693
Mailing Address - Fax:
Practice Address - Street 1:7243 REUTER ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-1545
Practice Address - Country:US
Practice Address - Phone:313-285-4693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies