MEDICARE: HEALTH CARE PLUS CONSULTING 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
1	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1679781371
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH CARE PLUS CONSULTING LLC

Provider Business Mailing Address
First Line	:	PO BOX 37648
Second Line	:
City	:	OAK PARK
State	:	MI
Zip	:	48237-0648
Country	:	US
Telephone Number	:	313-300-3738
Fax Number	:	313-449-5862

Provider Business Practice Location Address
First Line	:	17144 KENTUCKY ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48221-2447
Country	:	US
Telephone Number	:	313-300-3738
Fax Number	:	313-449-5862

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANDREA J PENNINGTON
Credential	:	MD
Telephone Number	:	313-300-3738

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	08/22/2020

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