Provider Demographics
NPI:1356500862
Name:SAV ON HOME HEALTHCARE SUPPLY INC
Entity type:Organization
Organization Name:SAV ON HOME HEALTHCARE SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT - PHARMACY OPERATION
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:MAC
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:734-377-3154
Mailing Address - Street 1:34550 GLENDALE ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1304
Mailing Address - Country:US
Mailing Address - Phone:734-525-1700
Mailing Address - Fax:734-525-1808
Practice Address - Street 1:22981 HALL RD
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:MI
Practice Address - Zip Code:48183-1539
Practice Address - Country:US
Practice Address - Phone:734-675-2211
Practice Address - Fax:734-675-3961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301007384332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5301007384OtherMICHIGAN PHARMACY LICENSE
MI2310732OtherNCPDP IDENTIFICATION NUMBER
MI540H219290OtherBLUE CROSS BLUE SHIELD MICHIGAN DME PROVIDER ID
MI4838977Medicaid
MI4838977Medicaid
MI540H219290OtherBLUE CROSS BLUE SHIELD MICHIGAN DME PROVIDER ID