1326096629 NPI number — REGENTS OF THE UNIVERSITY OF MICHIGAN

Table of content: (NPI 1326096629)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326096629 NPI number — REGENTS OF THE UNIVERSITY OF MICHIGAN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REGENTS OF THE UNIVERSITY OF MICHIGAN
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HOMEMED
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326096629
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/09/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 223248
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15251-2248
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-975-3006
Provider Business Mailing Address Fax Number:
734-975-3079

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2850 S. INDUSTRIAL HWY.
Provider Second Line Business Practice Location Address:
SUITE 50
Provider Business Practice Location Address City Name:
ANN ARBOR
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48104-9821
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-975-3006
Provider Business Practice Location Address Fax Number:
734-975-3079
Provider Enumeration Date:
05/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MILLER
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
CHRISTOPHER
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
734-936-3568

Provider Taxonomy Codes

  • Taxonomy code: 251F00000X , with the licence number:  5301005698 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X , with the licence number: 5301005698 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X , with the licence number: 5301005698 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 5301005698 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336H0001X , with the licence number: 5301005698 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336S0011X , with the licence number: 5301005698 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0883058 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4470923 . This is a "AETNA" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 2349973 . This is a "NCPDP/NAPB" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 470H10006 . This is a "BCBS OF MICHIGAN - HIT" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 540H103110 . This is a "BCBS OF MI - DME SUPPLIES" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 01000482 . This is a "HEALTH PLUS OF MI - MCD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 104041 . This is a "CARE CHOICES" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 874887962 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470H100060 . This is a "BLUE CARE NETWORK" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 504887962 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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