1598815912 NPI number — PROJECT COMPASSION HEALTH

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 1598815912 NPI number — PROJECT COMPASSION HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PROJECT COMPASSION HEALTH
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:
6
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:
1598815912
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/24/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4100 PIER NORTH BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLINT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48504
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-262-7389
Provider Business Mailing Address Fax Number:
989-652-3929

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33600 LUTHER LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIVONIA
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48154-5477
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-421-6564
Provider Business Practice Location Address Fax Number:
734-524-9379
Provider Enumeration Date:
01/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STORMS
Authorized Official First Name:
AMY
Authorized Official Middle Name:
E
Authorized Official Title or Position:
SVP/CFO
Authorized Official Telephone Number:
989-262-7389

Provider Taxonomy Codes

  • Taxonomy code: 332BN1400X , with the licence number:  824028 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 314000000X , with the licence number: 824028 , 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)

  • Identifier: 09863 . This is a "BCBSM" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0H22545 . This is a "BCBS DME P&O" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 4622395 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com