Healthcare Provider Details

I. General information

NPI: 1780805416
Provider Name (Legal Business Name): MIDMICHIGAN VISITING NURSE ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 12/11/2019
Certification Date: 12/11/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 E WARWICK DR
ALMA MI
48801
US

IV. Provider business mailing address

3007 N SAGINAW RD
MIDLAND MI
48640-4555
US

V. Phone/Fax

Practice location:
  • Phone: 989-463-4121
  • Fax:
Mailing address:
  • Phone: 989-633-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MRS. KATIE LEANNE CASTILLO
Title or Position: REGULATORY COORDINATOR
Credential:
Phone: 989-633-0749