Lakeside Transport Group, Inc

Primary specialty

Transportation BrokerTaxonomy code 347E00000X

License

L1582 Issued in MI

Legal business name

LAKESIDE TRANSPORT GROUP, INC

Practice address

24724 Farmbrook Rd
Southfield, MI 48034-1211

Phone

(248) 228-2266

NPI assigned

Aug 19, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Domonique Clements

Title

Manager

Phone

(248) 228-2266

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376870400000",
    "number": "1568895027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24724 FARMBROOK RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341211",
            "telephone_number": "248-228-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24724 FARMBROOK RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341211",
            "telephone_number": "248-228-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE TRANSPORT GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-19",
        "last_updated": "2013-08-19",
        "status": "A",
        "authorized_official_last_name": "CLEMENTS",
        "authorized_official_first_name": "DOMONIQUE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "248-228-2266",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": "MI",
            "license": "L1582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Transportation Broker in Southfield, MI
• Providers in Southfield, MI by specialty
• Transportation Broker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.