Healthcare Provider Details

I. General information

NPI: 1932832136
Provider Name (Legal Business Name): ECARE INFUSION CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2022
Last Update Date: 10/15/2022
Certification Date: 10/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5820 N CANTON CENTER RD STE 182
CANTON MI
48187-2651
US

IV. Provider business mailing address

5820 N CANTON CENTER RD STE 182
CANTON MI
48187-2651
US

V. Phone/Fax

Practice location:
  • Phone: 877-882-4480
  • Fax: 248-800-7272
Mailing address:
  • Phone: 877-882-4480
  • Fax: 248-800-7272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MANAL CHEHADEH
Title or Position: ADMINISTOR
Credential:
Phone: 877-882-4480