MEDICARE: SWIFT HOME CARE 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1881882140
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWIFT HOME CARE LLC

Provider Business Mailing Address
First Line	:	28303 DEQUINDRE RD
Second Line	:	120
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-3040
Country	:	US
Telephone Number	:	248-398-8827
Fax Number	:	248-398-8894

Provider Business Practice Location Address
First Line	:	28303 DEQUINDRE RD
Second Line	:	120
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-3040
Country	:	US
Telephone Number	:	248-398-8827
Fax Number	:	248-398-8894

Authorized Official
Title or Position	:	CEO
Name	:	RAYAN JABBAR MOHAMED ALI
Credential	:
Telephone Number	:	248-398-8827

Provider Enumeration Date	:	10/11/2007
Last Update Date	:	09/09/2010

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