MEDICARE: EDMOND & WILLIAMS CO.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
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1316887003
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDMOND & WILLIAMS CO.LLC

Provider Business Mailing Address
First Line	:	5596 COOPER ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48213-3079
Country	:	US
Telephone Number	:	313-757-1487
Fax Number	:

Provider Business Practice Location Address
First Line	:	5596 COOPER ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48213-3079
Country	:	US
Telephone Number	:	313-757-1487
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICE
Name	:	KENYA WILLIAMS
Credential	:
Telephone Number	:	313-757-1487

Provider Enumeration Date	:	03/31/2026
Last Update Date	:	03/31/2026

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