MEDICARE: VISITING NURSE SERVICES OF MICHIGAN

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1780760512
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISITING NURSE SERVICES OF MICHIGAN

Provider Business Mailing Address
First Line	:	1515 CAL DR
Second Line	:	PATIENT ACCOUNTS, 3RD FLOOR
City	:	DAVISON
State	:	MI
Zip	:	48423-9016
Country	:	US
Telephone Number	:	810-496-8641
Fax Number	:	810-496-8655

Provider Business Practice Location Address
First Line	:	4845 24TH AVE
Second Line	:
City	:	FORT GRATIOT
State	:	MI
Zip	:	48059-3407
Country	:	US
Telephone Number	:	810-385-5963
Fax Number	:	810-385-5967

Authorized Official
Title or Position	:	DIRECTOR
Name	:	STEVE LOY
Credential	:
Telephone Number	:	810-496-8633

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	03/25/2008

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