MEDICARE: JEFFREY SCHULTZ

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	:	1538611330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY SCHULTZ

Provider Business Mailing Address
First Line	:	18555 FORT ST
Second Line	:	SUITE A
City	:	RIVERVIEW
State	:	MI
Zip	:	48193-7436
Country	:	US
Telephone Number	:	734-258-8896
Fax Number	:

Provider Business Practice Location Address
First Line	:	18555 FORT ST
Second Line	:	SUITE A
City	:	RIVERVIEW
State	:	MI
Zip	:	48193-7436
Country	:	US
Telephone Number	:	734-258-8896
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2016
Last Update Date	:	10/27/2016

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Directions to “ JEFFREY SCHULTZ ” Practice Location

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