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General NPI Number Information
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NPI Number | 1427268135
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Entity Type | Organization
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Legal Business Name | HOME I V CARE INC
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 10/12/2022
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Provider Practice Location Address
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Address Line | 32751 EDWARD AVE SUITE 101
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071-1422
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Country | US
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Telephone | 248-577-5670
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Fax | 248-577-5660
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Provider Business Mailing Address
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Address Line | 32751 EDWARD AVE SUITE 101
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071-1422
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Country | US
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Telephone | 248-577-5670
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Fax | 248-577-5660
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Authorized Official
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Title or Position | PRESIDENT & C.E.O.
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Name | JEFFERY BISMACK
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Credential | R.PH., M.B.A.
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Telephone | 248-577-5670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | 5301005947
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License Number State | MI
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