Healthcare Provider Details

I. General information

NPI: 1699596874
Provider Name (Legal Business Name): ZOMACARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 10/21/2024
Certification Date: 10/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2888 E LONG LAKE RD STE 145
TROY MI
48085-7010
US

IV. Provider business mailing address

3013 DEBRA CT
AUBURN HILLS MI
48326-2043
US

V. Phone/Fax

Practice location:
  • Phone: 248-385-3578
  • Fax: 248-963-0956
Mailing address:
  • Phone: 586-914-0649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: FURAT J ZOMA
Title or Position: OWNER
Credential:
Phone: 586-914-0649