Provider Demographics
NPI:1275824468
Name:1ST ASSURANCE BILLING SERVICES LLC
Entity Type:Organization
Organization Name:1ST ASSURANCE BILLING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OW NER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:L
Authorized Official - Last Name:MACHUGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-771-3164
Mailing Address - Street 1:8126 HARBOR POINTE
Mailing Address - Street 2:
Mailing Address - City:GROSSE ILE
Mailing Address - State:MI
Mailing Address - Zip Code:48138-1084
Mailing Address - Country:US
Mailing Address - Phone:734-771-3164
Mailing Address - Fax:
Practice Address - Street 1:8126 HARBOR POINTE
Practice Address - Street 2:
Practice Address - City:GROSSE ILE
Practice Address - State:MI
Practice Address - Zip Code:48138-1084
Practice Address - Country:US
Practice Address - Phone:734-771-3164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health