MEDICARE: ENTECH MEDICAL STAFFING

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	374U00000X	Home Health Aide
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1982323499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENTECH MEDICAL STAFFING

Provider Business Mailing Address
First Line	:	1800 CROOKS ROAD
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48084-5446
Country	:	US
Telephone Number	:	248-528-8090
Fax Number	:	248-528-6983

Provider Business Practice Location Address
First Line	:	1800 CROOKS ROAD
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48084-5446
Country	:	US
Telephone Number	:	248-528-8090
Fax Number	:	248-528-6983

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	MS. AMY ELIZABETH GROSS
Credential	:
Telephone Number	:	248-743-1440

Provider Enumeration Date	:	08/26/2022
Last Update Date	:	08/26/2022

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