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General NPI Number Information
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NPI Number | 1649524331
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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 | 11/01/2012
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Last Update Date | 02/08/2021
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Provider Practice Location Address
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Address Line | 1000 HEALTH PARK BLVD SUITE A
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City | GRAND BLANC
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State | MI
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Zip | 48439-7324
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Country | US
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Telephone | 810-344-8383
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Fax | 855-348-3351
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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 | 615-309-5668
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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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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 | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | 5301009994
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License Number State | MI
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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 |
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License Number State | MI
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