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General NPI Number Information
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NPI Number | 1558456301
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Entity Type | Organization
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Legal Business Name | MITCHELL HOME MEDICAL, INC.
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 02/18/2008
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Provider Practice Location Address
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Address Line | 455 E GRAND RIVER AVE STE 206
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City | BRIGHTON
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State | MI
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Zip | 48116-1551
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Country | US
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Telephone | 810-229-9200
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Fax | 810-229-9260
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Provider Business Mailing Address
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Address Line | 4811 CARPENTER RD
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City | YPSILANTI
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State | MI
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Zip | 48197-9609
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Country | US
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Telephone | 734-572-0203
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Fax | 734-572-0281
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Authorized Official
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Title or Position | PRESIDENT
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Name | MITCHELL W MICHALUK III
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Credential |
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Telephone | 734-572-0203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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