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General NPI Number Information
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NPI Number | 1417659418
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Entity Type | Organization
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Legal Business Name | GENERATIONS SG ENTERPRISE
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Dates
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Enumeration Date | 03/21/2023
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Last Update Date | 03/21/2023
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Provider Practice Location Address
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Address Line | 18949 PEMBRIDGE ST
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City | MACOMB
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State | MI
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Zip | 48042-6308
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Country | US
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Telephone | 586-873-7753
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Fax |
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Provider Business Mailing Address
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Address Line | 8826 SAN MARCO BLVD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48313-4864
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Country | US
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Telephone | 586-873-7753
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ANGELA HAMELIN
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Credential |
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Telephone | 586-873-7753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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