Healthcare Provider Details

I. General information

NPI: 1053589200
Provider Name (Legal Business Name): EAGLE INTEGRATED HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 PACKARD ST SUITE 180
ANN ARBOR MI
48108-5000
US

IV. Provider business mailing address

3820 PACKARD ST SUITE 180
ANN ARBOR MI
48108-5000
US

V. Phone/Fax

Practice location:
  • Phone: 734-973-7764
  • Fax: 734-973-7897
Mailing address:
  • Phone: 734-973-7764
  • Fax: 734-973-7897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JOSEPHINE C AKUNNE
Title or Position: PRESIDENT/CEO
Credential: R. PH., PHARM. D.
Phone: 734-973-7764