Provider Demographics
NPI:1578694725
Name:PERSONAL HOME CARE MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:PERSONAL HOME CARE MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-779-7770
Mailing Address - Street 1:43900 SCHOENHERR RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-1120
Mailing Address - Country:US
Mailing Address - Phone:586-737-2323
Mailing Address - Fax:586-737-2345
Practice Address - Street 1:43900 SCHOENHERR RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-1120
Practice Address - Country:US
Practice Address - Phone:586-737-2323
Practice Address - Fax:586-737-2345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1325820001Medicare ID - Type Unspecified