Pristine Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PRISTINE MEDICAL LLC

Practice address

1502 W West Maple Rd
Walled Lake, MI 48390-2945

Phone

(248) 207-4358

NPI assigned

Jun 24, 2009

Organization subpart

No

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

Authorized official

Name

Jeff St. Louis

Title

President

Phone

(248) 757-4710

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246838400000",
    "number": "1346478740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 CHURCH ST",
            "city": "SAINT IGNACE",
            "state": "MI",
            "postal_code": "497811602",
            "telephone_number": "248-757-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 W WEST MAPLE RD",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483902945",
            "telephone_number": "248-207-4358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISTINE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-24",
        "last_updated": "2009-07-06",
        "status": "A",
        "authorized_official_last_name": "ST. LOUIS",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-757-4710"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Walled Lake, MI
• Providers in Walled Lake, MI by specialty
• Durable Medical Equipment & Medical Supplies in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2009; 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.