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	5301006101	MI
2	3336C0003X	Community/Retail Pharmacy	5301006101	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	540D402840	OTHER	MI	BLUE CROSS BLUE SHIELD MICHIGAN DME PROVIDER ID
2	5301006101	OTHER	MI	MICHIGAN PHARMACY LICENSE
3	2353453	OTHER	MI	NCPDP IDENTIFICATION NUMBER
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669631164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAV ON HOME HEALTHCARE SUPPLY INC

Provider Business Mailing Address
First Line	:	21120 BRIDGE ST
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-4032
Country	:	US
Telephone Number	:	248-357-4550
Fax Number	:	248-357-2332

Provider Business Practice Location Address
First Line	:	2040 S CEDAR ST
Second Line	:
City	:	IMLAY CITY
State	:	MI
Zip	:	48444-9606
Country	:	US
Telephone Number	:	810-724-7692
Fax Number	:	810-724-6064

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

Provider Enumeration Date	:	06/09/2008
Last Update Date	:	03/07/2023

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Directions to “SAV ON HOME HEALTHCARE SUPPLY INC ” Practice Location

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