Baby Boomer Medical Supplies, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

BABY BOOMER MEDICAL SUPPLIES, LLC

Practice address

3058 Metro Pkwy
Suite 110
Sterling Heights, MI 48310-3671

Phone

(586) 698-2071

Fax

(586) 698-2074

NPI assigned

Jun 9, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Okezie Wachuku

Title

Ceo

Phone

(586) 698-2071

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276041600000",
    "number": "1922328210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3058 METRO PKWY",
            "address_2": "SUITE 110",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483103671",
            "telephone_number": "586-698-2071",
            "fax_number": "586-698-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3058 METRO PKWY",
            "address_2": "SUITE 110",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483103671",
            "telephone_number": "586-698-2071",
            "fax_number": "586-698-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BABY BOOMER MEDICAL SUPPLIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-09",
        "last_updated": "2010-06-09",
        "status": "A",
        "authorized_official_last_name": "WACHUKU",
        "authorized_official_first_name": "OKEZIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "586-698-2071",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marrouf Azar, MD
• Balsam Aziz, D.D.S.
• Rana Adnan Azzo, DDS
• Jenna Babcock, NP-C
• Susan Catherine Babst, MA, LPC, LLP
• Niharika Bachani
• Vera Bachuwa
• Back 2 Health Physical Therapy, LLC
• Gretchen Backer, PT
• Danny Robert Bacon II

• Durable Medical Equipment & Medical Supplies in Sterling Heights, MI
• Providers in Sterling Heights, 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 Jun 9, 2010; 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.