Provider Demographics
NPI:1659622017
Name:EXTRAORDINARY MEDICAL BILLING&CONSULTANT SERVICES
Entity Type:Organization
Organization Name:EXTRAORDINARY MEDICAL BILLING&CONSULTANT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MEDICAL BILLING SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHALVONTE
Authorized Official - Middle Name:R
Authorized Official - Last Name:CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-662-4921
Mailing Address - Street 1:2910 E GRIXDALE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48234-1547
Mailing Address - Country:US
Mailing Address - Phone:313-662-4921
Mailing Address - Fax:313-891-6224
Practice Address - Street 1:19964 ROGGE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-3031
Practice Address - Country:US
Practice Address - Phone:313-662-4921
Practice Address - Fax:313-891-6224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty