MEDICARE: ANDREA DAVENPORT

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	347C00000X	Private Vehicle	D116067609949	MI

General Provider Information

NPI Number	:	1851772529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA DAVENPORT

Provider Business Mailing Address
First Line	:	17321 INDIANA ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48221-2402
Country	:	US
Telephone Number	:	313-420-9633
Fax Number	:

Provider Business Practice Location Address
First Line	:	17321 INDIANA ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48221-2402
Country	:	US
Telephone Number	:	313-420-9633
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2015
Last Update Date	:	06/17/2015

Similar Medicare Providers

1033142948 — HEALTHY LIVING MEDICAL SUPPLY, LLC
Practice Location Address:

1401 VERMONT ST STE 110
DETROIT, MI
48216-2402

Practice Phone: 866-779-8512
Practice Fax: 866-779-8511

1114167111 — SOLARA MEDICAL SUPPLIES, LLC
Practice Location Address:

1401 VERMONT ST STE 115
DETROIT, MI
48216-2402

Practice Phone: 888-688-1455
Practice Fax:

1306163811 — MIND OF CHRIST OUTREACH MINISTRY CHURCH
Practice Location Address:

2297 W EUCLID ST
DETROIT, MI
48206-2402

Practice Phone: 313-938-9072
Practice Fax: 951-735-0181

1275898876 — KATHRYN ANN SUTTON MA, LPC, NCC
Practice Location Address:

3500 JOHN R ST
DETROIT, MI
48201-2402

Practice Phone: 313-202-6106
Practice Fax: 313-202-6152

1699466375 — IAN P APOSTAL PHARMD
Practice Location Address:

2237 W EUCLID ST
DETROIT, MI
48206-2402

Practice Phone: 734-756-1152
Practice Fax:

1104636364 — R.U.S.H SERVICING LLC
Practice Location Address:

10620 LAKEPOINTE ST
DETROIT, MI
48224-2402

Practice Phone: 586-215-1574
Practice Fax:

Directions to “ ANDREA DAVENPORT ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.