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NPI Code Detail

MEDICARE: SARANDA PRIDE-MUMFORD

MEDICARE:   SARANDA  PRIDE-MUMFORD
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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1780535658
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARANDA PRIDE-MUMFORD
Provider Business Mailing Address
First Line : 33030 VAN BORN RD
Second Line :
City : WAYNE
State : MI
Zip : 48184-2453
Country : US
Telephone Number : 734-467-3424
Fax Number : 734-467-3424
Provider Business Practice Location Address
First Line : 33030 VAN BORN RD
Second Line :
City : WAYNE
State : MI
Zip : 48184-2453
Country : US
Telephone Number : 734-467-3424
Fax Number : 734-467-3424
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2026
Last Update Date : 02/06/2026

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Directions to “ SARANDA PRIDE-MUMFORD ” Practice Location

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