MEDICARE: WHITNEY HEALTH CARE SERVICES INC

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	332B00000X	Durable Medical Equipment & Medical Supplies	5301005009	MI

Other Identifiers

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

General Provider Information

NPI Number	:	1972555233
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHITNEY HEALTH CARE SERVICES INC

Provider Business Mailing Address
First Line	:	404 W COMMERCE DR
Second Line	:	SUITE A
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-9854
Country	:	US
Telephone Number	:	231-943-0600
Fax Number	:	231-943-0698

Provider Business Practice Location Address
First Line	:	4000 EASTERN SKY DR
Second Line	:	SUITE 1
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-7351
Country	:	US
Telephone Number	:	231-947-6921
Fax Number	:	231-947-4579

Authorized Official
Title or Position	:	OWNER - PRESIDENT
Name	:	MR. JAMES W BOCK
Credential	:	RPH
Telephone Number	:	231-943-0600

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	06/29/2012

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Directions to “WHITNEY HEALTH CARE SERVICES INC ” Practice Location

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