1831582493 NPI number — EMERALD PRIVATE DUTY HOME CARE LLC

Table of content: DR. TRENT RONALD STEENBLOCK DPM (NPI 1295710812)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831582493 NPI number — EMERALD PRIVATE DUTY HOME CARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMERALD PRIVATE DUTY HOME CARE LLC
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:
1831582493
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/06/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
48645 VAN DYKE AVE STE 110
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHELBY TWP
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48317-2575
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
586-731-6639
Provider Business Mailing Address Fax Number:
586-731-3209

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
48645 VAN DYKE AVE STE 110
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHELBY TWP
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48317-2575
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-731-6639
Provider Business Practice Location Address Fax Number:
586-731-3209
Provider Enumeration Date:
03/06/2015

Additional Information

Authorized Official

Authorized Official Last Name:
PRUTEANU
Authorized Official First Name:
ANNE-MARIE
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
586-731-6639

Provider Taxonomy Codes

  • Taxonomy code: 385H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2026 www.npivalidator.com