Provider Demographics
NPI:1497789689
Name:AEGIS PRO CARE INC
Entity Type:Organization
Organization Name:AEGIS PRO CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSHIYOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-702-6080
Mailing Address - Street 1:PO BOX 252471
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48325-2471
Mailing Address - Country:US
Mailing Address - Phone:248-702-6080
Mailing Address - Fax:248-702-6081
Practice Address - Street 1:30777 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 202
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2549
Practice Address - Country:US
Practice Address - Phone:248-702-6080
Practice Address - Fax:248-702-6081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237661Medicare Oscar/Certification