Provider Demographics
NPI:1720023609
Name:VISITING NURSE SERVICE OF MICHIGAN, INC.
Entity Type:Organization
Organization Name:VISITING NURSE SERVICE OF MICHIGAN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SURJIT
Authorized Official - Middle Name:K
Authorized Official - Last Name:KOHLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-968-8400
Mailing Address - Street 1:21700 GREENFIELD RD
Mailing Address - Street 2:SUITE 236
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237
Mailing Address - Country:US
Mailing Address - Phone:248-968-8400
Mailing Address - Fax:248-968-8401
Practice Address - Street 1:21700 GREENFIELD RD
Practice Address - Street 2:SUITE 236
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237
Practice Address - Country:US
Practice Address - Phone:248-968-8400
Practice Address - Fax:248-968-8401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E994OtherBBCBS OF MICHIGAN
MI237649Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER