MEDICARE: SAV ON HOME HEALTHCARE SUPPLY INC

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	332B00000X	Durable Medical Equipment & Medical Supplies	5301007855	MI
2	3336C0003X	Community/Retail Pharmacy	5301007855	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2336887	OTHER		NCPDP ID NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578749909
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAV ON HOME HEALTHCARE SUPPLY INC

Provider Business Mailing Address
First Line	:	34550 GLENDALE ST
Second Line	:
City	:	LIVONIA
State	:	MI
Zip	:	48150-1304
Country	:	US
Telephone Number	:	734-525-1700
Fax Number	:	734-525-1808

Provider Business Practice Location Address
First Line	:	225 E STATE ST
Second Line	:
City	:	MONTROSE
State	:	MI
Zip	:	48457-9004
Country	:	US
Telephone Number	:	810-639-2071
Fax Number	:	810-639-6179

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. ANDREW JAMES MAC
Credential	:	R.PH.
Telephone Number	:	734-377-3154

Provider Enumeration Date	:	01/16/2008
Last Update Date	:	03/24/2011

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