Healthcare Provider Details

I. General information

NPI: 1558869180
Provider Name (Legal Business Name): ASTER CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2018
Last Update Date: 01/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 HENRIETTA ST
BIRMINGHAM MI
48009-4112
US

IV. Provider business mailing address

1015 HENRIETTA ST
BIRMINGHAM MI
48009-4112
US

V. Phone/Fax

Practice location:
  • Phone: 248-808-0331
  • Fax:
Mailing address:
  • Phone: 248-808-0331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number4704249183
License Number StateMI

VIII. Authorized Official

Name: MS. REANETTA CHARESE JAMES
Title or Position: ADMINISTER
Credential: RN
Phone: 248-808-0331