PRISTINE MEDICAL LLC (NPI# 1346478740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346478740 |
| Entity Type | Organization |
| Organization Name | PRISTINE MEDICAL LLC |
| Practice Address |
1502 W West Maple Rd Walled Lake MI 48390-2945 |
| Mailing Address |
180 Church St Saint Ignace MI 49781-1602 |
| Practice Telephone | 2482074358 |
| Mailing Telephone | 2487574710 |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2009-07-06 |
| Authorized Official Name | JEFF ST. LOUIS (PRESIDENT) |
| Authorized Official Telephone | 2487574710 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332900000X | Non-Pharmacy Dispensing Site | Suppliers | ||
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | PRISTINE MEDICAL LLC | 4040 East Mcdowell Road, Suite 119, Phoenix, Az 85008 |
| Street Address |
1502 W WEST MAPLE RD |
| City | WALLED LAKE |
| State | MI |
| Zip Code | 48390-2945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043820913 | Elizabeth Ann Manela | Speech-Language Pathologist | 2075 East West Maple Road, Suite B203, Walled Lake, MI 48390 | 2020-08-05 |
| 1205459674 | Allor Outdoor Services LLC | Chore Provider | 3225 E Oakley Park Rd, Commerce Twp, MI 48390 | 2020-05-20 |
| 1467004382 | Convenient Cm PC | Dentist | 2655 Oakley Park Rd, Suite 101, Commerce Twp, MI 48390 | 2019-07-11 |
| 1629535117 | Valerie Baunoch | Nurse Practitioner | 2057 E West Maple Rd, Commerce Twp, MI 48390 | 2019-02-21 |
| 1255858296 | Finn Family Chiropractic Pllc | Chiropractor | 2344 South Commerce Road, Walled Lake, MI 48390 | 2017-08-29 |
| 1588012629 | Shane Macphee | Chiropractor | 2901 Commerce Crossings, Commerce Township, MI 48390 | 2016-05-31 |
| 1245690114 | Lisa Jensen | Nurse Practitioner | 100 West Maple Rd., Walled Lake, MI 48390 | 2016-03-04 |
| 1255725123 | Carissa Karanth | Counselor | 1500 Rustic Lane, Wolverine Lake, MI 48390 | 2015-03-27 |
| 1689095093 | Mabell Omoye Scott | Licensed Vocational Nurse | 724 Owl Court, Wolverine Lake, MI 48390 | 2014-01-02 |
| 1093002230 | Ilze Liene Junkulis-muller | Pharmacist | 495 Haggerty, Traget Pharmacy #0896, Walled Lake, MI 48390 | 2011-07-08 |
| Find all providers in zip 48390 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851401376 | Med Rent Inc | Durable Medical Equipment & Medical Supplies | 929 N Pontiac Trail, Walled Lake, MI 48390-3235 | 2006-08-30 |
| 1295845105 | Rite Aid of Michigan Inc | Durable Medical Equipment & Medical Supplies | 700 North Pontiac Trail, Walled Lake, MI 48390-3408 | 2006-08-30 |
| 1184049207 | Irb Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 39630 W 14 Mile Rd, Walled Lake, MI 48390-3909 | 2014-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972103257 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 555 Towner St Ste 1120d, Ypsilanti, MI 48198-5723 | 2020-10-27 |
| 1336747336 | Wheelchairs Outlet | Durable Medical Equipment & Medical Supplies | 5506 Maplebrook Ln, Flint, MI 48507-4160 | 2020-10-12 |
| 1205449543 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 608 Wright Ave Rm 106, Alma, MI 48801-1617 | 2020-08-26 |
| 1699386227 | Iha Health Service Corporation | Durable Medical Equipment & Medical Supplies | Iha Associates In Podiatry, 14555 Levan Road Suite 116, Livonia, MI 48154 | 2020-08-17 |
| 1134747363 | Quick Care Medical Devices, LLC | Durable Medical Equipment & Medical Supplies | 25500 Meadowbrook Rd 275b, Novi, MI 48375 | 2020-07-14 |
| 1457979858 | American Dental Care Lab LLC | Durable Medical Equipment & Medical Supplies | 9209 N Island Ct, Flushing, MI 48433-2934 | 2020-07-12 |
| 1013535178 | Karmen Industries LLC | Durable Medical Equipment & Medical Supplies | 4225 Tanglewood Trl, Saint Joseph, MI 49085-9647 | 2020-07-06 |
| 1972126126 | Boss and Rorvik Family Dental, Pllc | Durable Medical Equipment & Medical Supplies | 1504 Harcrest Dr Ste 2, Midland, MI 48640-4717 | 2020-05-22 |
| 1720600463 | Milk Moves LLC | Durable Medical Equipment & Medical Supplies | 18032 James Couzens Fwy, Detroit, MI 48235-2646 | 2020-05-15 |
| 1225658818 | Aen Sports, LLC | Durable Medical Equipment & Medical Supplies | 40417 Beechwood Ct, Northville, MI 48168-3418 | 2020-04-23 |
| Find all providers with the same taxonomy | ||||
| City | WALLED LAKE |
| Zip Code | 48390 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.