Provider Demographics
NPI:1376790279
Name:SVC INC.
Entity Type:Organization
Organization Name:SVC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:RAYMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-619-9362
Mailing Address - Street 1:675 E BIG BEAVER RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1418
Mailing Address - Country:US
Mailing Address - Phone:248-619-9362
Mailing Address - Fax:248-619-9371
Practice Address - Street 1:675 E BIG BEAVER RD
Practice Address - Street 2:SUITE 211
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1418
Practice Address - Country:US
Practice Address - Phone:248-619-9362
Practice Address - Fax:248-619-9371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5102160001Medicare NSC
MI0N76350Medicare PIN
MI5102160001Medicare PIN