Healthcare Provider Details

I. General information

NPI: 1538249586
Provider Name (Legal Business Name): READY CARE GRAND LEDGE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 12/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

644 MIGALDI LANE SUITE 300
LANSING MI
48917-7750
US

IV. Provider business mailing address

644 MIGALDI LANE SUITE 300
LANSING MI
48917-7750
US

V. Phone/Fax

Practice location:
  • Phone: 517-627-6024
  • Fax: 517-627-9339
Mailing address:
  • Phone: 517-627-6024
  • Fax: 517-627-9339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301037074
License Number StateMI

VIII. Authorized Official

Name: FARROKH RAHNEMOON
Title or Position: OWNER
Credential: MD
Phone: 517-627-6024