Healthcare Provider Details

I. General information

NPI: 1487876041
Provider Name (Legal Business Name): MIDMICHIGAN VISITING NURSE ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1432 N MCEWAN ST
CLARE MI
48617
US

IV. Provider business mailing address

3007 N SAGINAW RD
MIDLAND MI
48640-4555
US

V. Phone/Fax

Practice location:
  • Phone: 989-802-5010
  • Fax: 989-802-5013
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: RENAE LYNN FOCO
Title or Position: MANAGER PATIENT ACCOUNTING
Credential:
Phone: 989-633-5227