Provider Demographics
NPI:1285817957
Name:EASTERN MICHIGAN HOME HEALTH CARE, PC
Entity Type:Organization
Organization Name:EASTERN MICHIGAN HOME HEALTH CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:IKRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HAQ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:248-397-8096
Mailing Address - Street 1:4045 W 13 MILE RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6640
Mailing Address - Country:US
Mailing Address - Phone:248-397-8096
Mailing Address - Fax:
Practice Address - Street 1:4045 W 13 MILE RD
Practice Address - Street 2:SUITE D
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6640
Practice Address - Country:US
Practice Address - Phone:248-397-8096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI239079Medicare Oscar/Certification