Healthcare Provider Details

I. General information

NPI: 1063480705
Provider Name (Legal Business Name): HETCH-CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 11/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3558 THOMAS RD
OXFORD MI
48371-1438
US

IV. Provider business mailing address

3558 THOMAS RD
OXFORD MI
48371-1438
US

V. Phone/Fax

Practice location:
  • Phone: 248-969-2266
  • Fax: 248-969-9611
Mailing address:
  • Phone: 248-969-2266
  • Fax: 248-969-9611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. SANDRA L HETCHLER
Title or Position: CEO
Credential:
Phone: 248-969-2266