Provider Demographics
NPI:1013184795
Name:SAV ON HOME HEALTH CARE SUPPLY, INC.
Entity Type:Organization
Organization Name:SAV ON HOME HEALTH CARE SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT - PHARMACY OPERATION
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:MAC
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:734-377-3154
Mailing Address - Street 1:34550 GLENDALE ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1304
Mailing Address - Country:US
Mailing Address - Phone:734-377-3154
Mailing Address - Fax:734-345-3525
Practice Address - Street 1:35 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-5610
Practice Address - Country:US
Practice Address - Phone:586-468-0597
Practice Address - Fax:586-468-6732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301008569332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
2366157OtherNCPDP ID
MI5301008569OtherPHARMACY LICENSE
MI000815917OOtherAMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS AND PEDORTHOTICS INC
MI2366157Medicaid
MI2366157Medicaid
MI5301008569OtherPHARMACY LICENSE