Life Extension Medical Equipment LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

B Issued in MI

Legal business name

LIFE EXTENSION MEDICAL EQUIPMENT LLC

Practice address

29350 Southfield Rd
Suite 115
Southfield, MI 48076-2053

Phone

(248) 395-1511

NPI assigned

Jun 29, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Azhar Ul Islam

Title

President

Phone

(248) 280-3820

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1386672004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 W 14 MILE RD",
            "address_2": "SUITE 207",
            "city": "CLAWSON",
            "state": "MI",
            "postal_code": "480173104",
            "telephone_number": "248-280-3820",
            "fax_number": "248-280-3823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29350 SOUTHFIELD RD",
            "address_2": "SUITE 115",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762053",
            "telephone_number": "248-395-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE EXTENSION MEDICAL EQUIPMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ISLAM",
        "authorized_official_first_name": "AZHAR",
        "authorized_official_middle_name": "UL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-280-3820",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Southfield, MI
• Providers in Southfield, 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 21, 2022; 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.