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General NPI Number Information
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NPI Number | 1689512899
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Entity Type | Organization
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Legal Business Name | BIRDIE MAE'S BRUNCH BAR
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Dates
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Enumeration Date | 03/23/2026
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 6381 W OUTER DR
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City | DETROIT
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State | MI
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Zip | 48235-2719
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Country | US
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Telephone | 248-605-1516
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Fax |
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Provider Business Mailing Address
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Address Line | 6381 W OUTER DR
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City | DETROIT
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State | MI
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Zip | 48235-2719
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Country | US
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Telephone | 248-605-1516
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CIERRA MCFARLIN
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Credential |
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Telephone | 248-605-1516
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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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Taxonomy #2
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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