1134306046 NPI number — MYMICHIGAN HOME CARE

Table of content: DR. MADELINE E. OVERMILLER DDS (NPI 1184292062)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134306046 NPI number — MYMICHIGAN HOME CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MYMICHIGAN HOME CARE
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:
1134306046
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6810 EASTMAN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIDLAND
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48642-7805
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-633-1400
Provider Business Mailing Address Fax Number:
989-633-1412

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6810 EASTMAN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDLAND
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48642-7805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-633-1400
Provider Business Practice Location Address Fax Number:
989-633-1412
Provider Enumeration Date:
01/23/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MELCHI
Authorized Official First Name:
PAMELA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PATIENT ACCOUNTING MANAGER
Authorized Official Telephone Number:
989-633-0746

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 540E611180 . This is a "BCBSM" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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