1235542960 NPI number — HARNOMY HEALTHCARE AND REHAB INC

Table of content: (NPI 1235542960)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235542960 NPI number — HARNOMY HEALTHCARE AND REHAB INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARNOMY HEALTHCARE AND REHAB 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:
1235542960
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/10/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4220 GLORIA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAYNE
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48184-2253
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
313-575-7000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26153 COLGATE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INKSTER
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48141-3279
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-575-7000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/10/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ODUKA
Authorized Official First Name:
JOHNSON
Authorized Official Middle Name:
UZOMAA
Authorized Official Title or Position:
PROVIDER/CEO
Authorized Official Telephone Number:
313-575-7000

Provider Taxonomy Codes

  • Taxonomy code: 320600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 320600000X , with the licence number: NONE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320600000X , with the licence number: NONE , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 322D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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