Provider Demographics
NPI:1376538199
Name:PROFESSIONAL HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:PROFESSIONAL HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHAUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-231-0858
Mailing Address - Street 1:25050 W. OUTER DRIVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LINCOLN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48146-1297
Mailing Address - Country:US
Mailing Address - Phone:734-667-3478
Mailing Address - Fax:734-667-3479
Practice Address - Street 1:25050 W. OUTER DRIVE
Practice Address - Street 2:SUITE 204
Practice Address - City:LINCOLN PARK
Practice Address - State:MI
Practice Address - Zip Code:48146-1297
Practice Address - Country:US
Practice Address - Phone:734-667-3478
Practice Address - Fax:734-667-3479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-19
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI237544251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237544Medicare ID - Type Unspecified