Healthcare Provider Details

I. General information

NPI: 1609927250
Provider Name (Legal Business Name): FRIENDLY HOME HEALTH EQUIPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 E MICHIGAN AVE
JACKSON MI
49202-3580
US

IV. Provider business mailing address

1801 PROBERT RD
JACKSON MI
49203-5214
US

V. Phone/Fax

Practice location:
  • Phone: 517-990-2771
  • Fax:
Mailing address:
  • Phone: 517-768-9310
  • Fax: 517-789-5505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberD
License Number StateMI

VIII. Authorized Official

Name: MR. NASIR AZ BASHIR
Title or Position: CHIEF OPERATING OFFICER
Credential: M.D.
Phone: 517-990-2771