Provider Demographics
NPI:1487821799
Name:HOME CARE DOCTORS PC
Entity Type:Organization
Organization Name:HOME CARE DOCTORS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRORAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-506-2037
Mailing Address - Street 1:PO BOX 2240
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48333-2240
Mailing Address - Country:US
Mailing Address - Phone:313-506-2037
Mailing Address - Fax:248-538-8942
Practice Address - Street 1:28230 ORCHARD LAKE RD
Practice Address - Street 2:STE 103
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3762
Practice Address - Country:US
Practice Address - Phone:313-506-2037
Practice Address - Fax:248-538-8942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301064583207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104091522Medicaid
MI104091522Medicaid
0M59720Medicare PIN