Provider Demographics
NPI:1760728968
Name:AMIRA MEDICAL STAFFING
Entity Type:Organization
Organization Name:AMIRA MEDICAL STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:M
Authorized Official - Last Name:COLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-730-5003
Mailing Address - Street 1:23902 FORD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-3246
Mailing Address - Country:US
Mailing Address - Phone:313-730-5003
Mailing Address - Fax:313-730-5011
Practice Address - Street 1:23902 FORD RD
Practice Address - Street 2:SUITE B
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-3246
Practice Address - Country:US
Practice Address - Phone:313-730-5003
Practice Address - Fax:313-730-5011
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMIRA MEDICAL STAFFING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care