1376538199 NPI number — PROFESSIONAL HOME HEALTH CARE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376538199 NPI number — PROFESSIONAL HOME HEALTH CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PROFESSIONAL HOME HEALTH CARE, INC.
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:
Provider Other Organization Name Type Code:
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:
1376538199
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/14/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25050 W. OUTER DRIVE
Provider Second Line Business Mailing Address:
SUITE 204
Provider Business Mailing Address City Name:
LINCOLN PARK
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48146-1297
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-667-3478
Provider Business Mailing Address Fax Number:
734-667-3479

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25050 W. OUTER DRIVE
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
LINCOLN PARK
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48146-1297
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-667-3478
Provider Business Practice Location Address Fax Number:
734-667-3479
Provider Enumeration Date:
09/19/2005

Additional Information

Authorized Official

Authorized Official Last Name:
CHAUDHRY
Authorized Official First Name:
MUHAMMAD
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
734-231-0858

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  237544 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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