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NPI Code Detail

MEDICARE: HEALTHCARE ADMINISTRATIVE SERVICES LLC

MEDICARE: HEALTHCARE ADMINISTRATIVE SERVICES 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
1208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1679823389
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHCARE ADMINISTRATIVE SERVICES LLC
Provider Business Mailing Address
First Line : 17950 WOODWARD AVE
Second Line : UPPER LEVEL
City : DETROIT
State : MI
Zip : 48203-2260
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 17950 WOODWARD AVE
Second Line : UPPER LEVEL
City : DETROIT
State : MI
Zip : 48203-2260
Country : US
Telephone Number : 313-656-7179
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MRS. LATOYIA JOHNSON
Credential :
Telephone Number : 313-656-7179
Provider Enumeration Date : 09/11/2012
Last Update Date : 09/11/2012

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Directions to “HEALTHCARE ADMINISTRATIVE SERVICES LLC ” Practice Location

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