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General NPI Number Information
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NPI Number | 1760898522
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Entity Type | Organization
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Legal Business Name | TRUCARE HOMECARE LLC
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Dates
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Enumeration Date | 07/01/2014
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Last Update Date | 07/01/2014
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Provider Practice Location Address
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Address Line | 20510 VAUGHAN ST
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City | DETROIT
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State | MI
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Zip | 48219-1453
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Country | US
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Telephone | 313-974-5902
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 972
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City | SOUTHFIELD
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State | MI
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Zip | 48037-0972
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/AUTHORIZED OFFICIAL
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Name | CAMERON AVERY
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Credential |
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Telephone | 313-974-5902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State | MI
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