Provider Demographics
NPI:1326096629
Name:REGENTS OF THE UNIVERSITY OF MICHIGAN
Entity Type:Organization
Organization Name:REGENTS OF THE UNIVERSITY OF MICHIGAN
Other - Org Name:HOMEMED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-936-3568
Mailing Address - Street 1:PO BOX 223248
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-2248
Mailing Address - Country:US
Mailing Address - Phone:734-975-3006
Mailing Address - Fax:734-975-3079
Practice Address - Street 1:2850 S. INDUSTRIAL HWY.
Practice Address - Street 2:SUITE 50
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-9821
Practice Address - Country:US
Practice Address - Phone:734-975-3006
Practice Address - Fax:734-975-3079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301005698251F00000X, 332B00000X, 332BP3500X, 3336C0003X, 3336H0001X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0883058Medicaid
MI4470923OtherAETNA
MI2349973OtherNCPDP/NAPB
MI470H10006OtherBCBS OF MICHIGAN - HIT
MI540H103110OtherBCBS OF MI - DME SUPPLIES
MI01000482OtherHEALTH PLUS OF MI - MCD
MI104041OtherCARE CHOICES
MI874887962Medicaid
MI470H100060OtherBLUE CARE NETWORK
MI504887962Medicaid
MI0H10311Medicare ID - Type UnspecifiedMEDICARE PART B
MI470H100060OtherBLUE CARE NETWORK