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NPI Code Detail

MEDICARE: CARE RESOURCE TEAM

MEDICARE: CARE RESOURCE TEAM
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
1251B00000XCase Management Agency
2251J00000XNursing Care Agency
3261QP2300XPrimary Care Clinic/Center
4305R00000XPreferred Provider Organization
5163WC1500XCommunity Health Registered Nurse

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740751346
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARE RESOURCE TEAM
Provider Business Mailing Address
First Line : 1327 SHERWOOD FOREST CT
Second Line :
City : WATERFORD
State : MI
Zip : 48327-1677
Country : US
Telephone Number : 248-421-7633
Fax Number :
Provider Business Practice Location Address
First Line : 5758 COOLEY LAKE RD
Second Line :
City : WATERFORD
State : MI
Zip : 48327-3073
Country : US
Telephone Number : 248-421-7633
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JERRI D MEDVED
Credential : RN
Telephone Number : 248-421-7633
Provider Enumeration Date : 12/08/2018
Last Update Date : 01/15/2019

Similar Medicare Providers

1023260494 — JULIE M SHEREDA
Practice Location Address:
5758 COOLEY LAKE RD
WATERFORD, MI
48327-3073
Practice Phone: 855-466-3631
Practice Fax: 810-244-0226
1417493065 — JESSICA MCDIARMID FNP
Practice Location Address:
5758 COOLEY LAKE RD
WATERFORD, MI
48327-3073
Practice Phone: 855-466-3631
Practice Fax: 810-244-0226
1447786207 — KATHERINE RAE HOLYFIELD MSN AGPCNP-C
Practice Location Address:
5758 COOLEY LAKE RD
WATERFORD, MI
48327-3073
Practice Phone: 855-466-3631
Practice Fax: 810-244-0226
1942721519 — LYNDA LAUER PENCE DNP, AGPCNP-BC
Practice Location Address:
5758 COOLEY LAKE RD
WATERFORD, MI
48327-3073
Practice Phone: 855-466-3631
Practice Fax:
1437667946 — JENNIFER LYNN FREY
Practice Location Address:
5758 COOLEY LAKE RD
WATERFORD, MI
48327-3073
Practice Phone: 855-466-3631
Practice Fax: 833-973-4493
1366916702 — MRS. SHANNA LYNN DRISCOLL RN, BSN
Practice Location Address:
5758 COOLEY LAKE RD
WATERFORD, MI
48327-3073
Practice Phone: 248-421-6000
Practice Fax:

Directions to “CARE RESOURCE TEAM ” Practice Location

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