MEDICARE: CARDINAL HEALTHCARE,LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1235342502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDINAL HEALTHCARE,LLC

Provider Business Mailing Address
First Line	:	1122 HARDING AVENUE
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307
Country	:	US
Telephone Number	:	278-601-2408
Fax Number	:	248-601-2420

Provider Business Practice Location Address
First Line	:	1122 HARDING AVE
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-2513
Country	:	US
Telephone Number	:	278-601-2408
Fax Number	:	248-601-2420

Authorized Official
Title or Position	:	PRINICPAL MEMBER
Name	:	MS. JUDY LYNN MALBURG
Credential	:	RN
Telephone Number	:	248-601-2408

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	08/22/2020

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