Lakeshore Medical Transport and Supply

Primary specialty

DriverTaxonomy code 172A00000X

Legal business name

LAKESHORE MEDICAL TRANSPORT AND SUPPLY

Practice address

11450 Minden St
Detroit, MI 48205-3763

Phone

(313) 437-3841

NPI assigned

Dec 4, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Donte Roberts

Title

President

Phone

(313) 329-8125

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625616000000",
    "number": "1073028890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11450 MINDEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482053763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11450 MINDEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482053763",
            "telephone_number": "313-437-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE MEDICAL TRANSPORT AND SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-04",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "DONTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-329-8125"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Violette Lake-Brown, PHARMACIST
• Bradley Allan Lake, LMSW
• Lakeridge Village, Inc.
• Lakeshore Healthcare Cranbrook Campus Inc
• Lakeshore Healthcare Elmwood Campus Inc
• Lakeside Global Transport, Inc
• Lakewood Dental Group III
• Terrence Lakey
• Ali Mohammed Lakhani, PTA
• Shikha Lakhani

• Driver in Detroit, MI
• Providers in Detroit, MI by specialty
• Driver in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.