Healthcare Provider Details

I. General information

NPI: 1811241508
Provider Name (Legal Business Name): ARK HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2012
Last Update Date: 11/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6050 GREENFIELD RD SUITE 101
DEARBORN MI
48126-6004
US

IV. Provider business mailing address

6050 GREENFIELD RD SUITE 101
DEARBORN MI
48126-6004
US

V. Phone/Fax

Practice location:
  • Phone: 313-945-9000
  • Fax: 313-945-7500
Mailing address:
  • Phone: 313-945-9000
  • Fax: 313-945-7500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. ALLIE GALOVICH
Title or Position: BILLER
Credential: CPC
Phone: 248-593-9780