Provider Demographics
NPI:1922259654
Name:SSAC, LLC
Entity Type:Organization
Organization Name:SSAC, LLC
Other - Org Name:ARCADIA RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPARLING
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:248-352-7530
Mailing Address - Street 1:26777 CENTRAL PARK BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-4162
Mailing Address - Country:US
Mailing Address - Phone:800-442-4579
Mailing Address - Fax:800-785-2177
Practice Address - Street 1:3524 PARK PLAZA RD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-8900
Practice Address - Country:US
Practice Address - Phone:248-352-7530
Practice Address - Fax:248-352-5189
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARCADIA PRODUCTS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-30
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP06890332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90007691Medicaid
5010280001Medicare NSC