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NPI Code Detail

MEDICARE: EASTWEST TECHNOLOGIES, LLC

MEDICARE: EASTWEST TECHNOLOGIES, 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
1251E00000XHome Health Agency383512826MI

General Provider Information

NPI Number : 1922129972
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASTWEST TECHNOLOGIES, LLC
Provider Business Mailing Address
First Line : 35452 MUSTANG DR
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48312-4067
Country : US
Telephone Number : 586-582-9690
Fax Number : 586-582-9590
Provider Business Practice Location Address
First Line : 31201 CHICAGO RD S
Second Line : SUITE B302
City : WARREN
State : MI
Zip : 48093-5527
Country : US
Telephone Number : 586-582-9690
Fax Number : 586-582-9590
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. BENJAMIN ROA ESPERE IV
Credential : RPT
Telephone Number : 586-489-4638
Provider Enumeration Date : 04/03/2007
Last Update Date : 11/02/2016

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Directions to “EASTWEST TECHNOLOGIES, LLC ” Practice Location

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