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General NPI Number Information
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NPI Number | 1487697983
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Entity Type | Organization
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Legal Business Name | REVERENCE HOME HEALTH & HOSPICE, LLC
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 28120 DEQUINDRE RD
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City | WARREN
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State | MI
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Zip | 48092-5603
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Country | US
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Telephone | 586-913-0333
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Fax | 888-474-3112
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Provider Business Mailing Address
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Address Line | 10 CADILLAC DR STE 400
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City | BRENTWOOD
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State | TN
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Zip | 37027-1001
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Country | US
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Telephone | 615-377-7022
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Fax | 615-373-4457
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Authorized Official
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Title or Position | SVP CHIEF LEGAL OFFICER
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Name | RUSSELL ADKINS
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Credential |
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Telephone | 615-926-0340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | 5301006796
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License Number State | MI
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Taxonomy #2
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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 #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail 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 | 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 #5
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | 5301006796
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License Number State | MI
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