Provider Demographics
NPI:1497187496
Name:MERIDIAN HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:MERIDIAN HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAMBABU
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVERNENI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-924-0493
Mailing Address - Street 1:43000 W 9 MILE RD
Mailing Address - Street 2:307A
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-4175
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:43000 W 9 MILE RD
Practice Address - Street 2:307A
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-4175
Practice Address - Country:US
Practice Address - Phone:248-924-0493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1150Other1150