Provider Demographics
NPI:1750111381
Name:J AMARRAH MEDICAL CARE SYSTEMS
Entity type:Organization
Organization Name:J AMARRAH MEDICAL CARE SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:G
Authorized Official - Last Name:SALAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-562-7716
Mailing Address - Street 1:29226 ORCHARD LAKE RD
Mailing Address - Street 2:SSTE 170
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2984
Mailing Address - Country:US
Mailing Address - Phone:248-562-7716
Mailing Address - Fax:248-562-7724
Practice Address - Street 1:29226 ORCHARD LAKE RD
Practice Address - Street 2:STE 170
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2984
Practice Address - Country:US
Practice Address - Phone:248-562-7716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty