Provider Demographics
NPI:1699881805
Name:DRS SERVICES INC
Entity type:Organization
Organization Name:DRS SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO COO
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:CEO COO
Authorized Official - Phone:248-356-5534
Mailing Address - Street 1:298 S OLD WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-6163
Mailing Address - Country:US
Mailing Address - Phone:248-356-5534
Mailing Address - Fax:248-352-3235
Practice Address - Street 1:298 S OLD WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-6163
Practice Address - Country:US
Practice Address - Phone:248-356-5534
Practice Address - Fax:248-352-3235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0D03640Medicaid
080F373970OtherBLUE CROSS
MI0D03640Medicaid