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NPI Code Detail

MEDICARE: MIDWEST CONNECTION LLC

MEDICARE: MIDWEST CONNECTION LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care Agency
2347C00000XPrivate Vehicle
3343900000XNon-emergency Medical Transport (VAN)

General Provider Information

NPI Number : 1003732017
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIDWEST CONNECTION LLC
Provider Business Mailing Address
First Line : 24225 W 9 MILE RD
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48033-3962
Country : US
Telephone Number : 947-281-7941
Fax Number :
Provider Business Practice Location Address
First Line : 24225 W 9 MILE RD
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48033-3962
Country : US
Telephone Number : 947-281-7941
Fax Number :
Authorized Official
Title or Position : ACCOUNT SPECIALIST
Name : TELRAH TANKSLEY
Credential :
Telephone Number : 947-281-7541
Provider Enumeration Date : 06/24/2026
Last Update Date : 06/24/2026

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Directions to “MIDWEST CONNECTION LLC ” Practice Location

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