Healthcare Provider Details

I. General information

NPI: 1306846332
Provider Name (Legal Business Name): AMBULATORY INFUSION CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2005
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 INDUSTRIAL PARK DR
MOUNT PLEASANT MI
48858
US

IV. Provider business mailing address

121 E. BROADWAY #C
MOUNT PLEASASNT MI
48858
US

V. Phone/Fax

Practice location:
  • Phone: 989-772-7770
  • Fax: 989-772-7490
Mailing address:
  • Phone: 989-773-4879
  • Fax: 989-773-5233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number5301005525
License Number StateMI

VIII. Authorized Official

Name: DR. GREGORY LAMAR MCCARTHY
Title or Position: OWNER
Credential: PHARM D
Phone: 989-773-4879