Provider Demographics
NPI:1972593143
Name:SOBAKS HOME MEDICAL INC.
Entity type:Organization
Organization Name:SOBAKS HOME MEDICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:BENGER
Authorized Official - Last Name:SOBAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-723-8927
Mailing Address - Street 1:112 W EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-2816
Mailing Address - Country:US
Mailing Address - Phone:989-723-8927
Mailing Address - Fax:989-725-5732
Practice Address - Street 1:1115 W BROAD ST
Practice Address - Street 2:
Practice Address - City:CHESANING
Practice Address - State:MI
Practice Address - Zip Code:48616-1068
Practice Address - Country:US
Practice Address - Phone:989-845-8927
Practice Address - Fax:989-845-5732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-27
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3102873Medicaid
MI0882730003Medicare ID - Type Unspecified