=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972092286
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NURSING MANAGEMENT SOLUTIONS (NMS)
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/02/2018
-----------------------------------------------------
Last Update Date | 05/02/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16151 MEYERS RD
-----------------------------------------------------
City | DETROIT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48235-4108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-412-3330
-----------------------------------------------------
Fax | 313-557-0135
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14057 ARCHDALE ST
-----------------------------------------------------
City | DETROIT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48227-1363
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-412-3330
-----------------------------------------------------
Fax | 313-557-0135
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. DOSHAUN R EDWARDS
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 313-412-3330
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 4704314433
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number | 4704314433
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------