Healthcare Provider Details

I. General information

NPI: 1881612398
Provider Name (Legal Business Name): MIDMICHIGAN VISITING NURSE ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 07/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3007 N SAGINAW RD
MIDLAND MI
48640
US

IV. Provider business mailing address

3007 N SAGINAW RD
MIDLAND MI
48640-4555
US

V. Phone/Fax

Practice location:
  • Phone: 989-633-1400
  • Fax: 989-633-1464
Mailing address:
  • Phone: 989-633-1400
  • Fax: 989-633-1464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number563510
License Number StateMI

VIII. Authorized Official

Name: RENAE LYNN FOCO
Title or Position: MANAGER PATIENT ACCOUNTING
Credential:
Phone: 989-633-5227