Provider Demographics
NPI:1821331372
Name:AMERICAN HEALTHCARE NETWORK LLC
Entity Type:Organization
Organization Name:AMERICAN HEALTHCARE NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:VAUGHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MASROPIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-376-0996
Mailing Address - Street 1:30201 ORCHARD LAKE RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2235
Mailing Address - Country:US
Mailing Address - Phone:248-905-1112
Mailing Address - Fax:888-965-9806
Practice Address - Street 1:30201 ORCHARD LAKE RD
Practice Address - Street 2:SUITE 115
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2235
Practice Address - Country:US
Practice Address - Phone:248-905-1112
Practice Address - Fax:888-965-9806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========OtherTAX ID