Provider Demographics
NPI:1639223423
Name:PATIENT FIRST HOME CARE, INC.
Entity Type:Organization
Organization Name:PATIENT FIRST HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WASIM
Authorized Official - Middle Name:
Authorized Official - Last Name:IQBAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-608-6246
Mailing Address - Street 1:2660 HORIZON DR SE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-7527
Mailing Address - Country:US
Mailing Address - Phone:616-608-6246
Mailing Address - Fax:616-608-6284
Practice Address - Street 1:2660 HORIZON DR SE
Practice Address - Street 2:SUITE 130
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-7527
Practice Address - Country:US
Practice Address - Phone:616-608-6246
Practice Address - Fax:616-608-6284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI23-7616251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI15-4968381Medicaid
7404893OtherAETNA
MI15-4968381Medicaid