Provider Demographics
NPI:1073515664
Name:MIDMICHIGAN INFUSION CARE
Entity Type:Organization
Organization Name:MIDMICHIGAN INFUSION CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMASKI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:800-732-4879
Mailing Address - Street 1:4568 M 30
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:MI
Mailing Address - Zip Code:48612-8548
Mailing Address - Country:US
Mailing Address - Phone:989-435-2631
Mailing Address - Fax:989-435-2801
Practice Address - Street 1:4568 M 30
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:MI
Practice Address - Zip Code:48612-8548
Practice Address - Country:US
Practice Address - Phone:989-435-2631
Practice Address - Fax:989-435-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301007845251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion