Provider Demographics
NPI:1780736264
Name:MERCY GENERAL HEALTH PARTNERS AMICARE HOMECARE
Entity type:Organization
Organization Name:MERCY GENERAL HEALTH PARTNERS AMICARE HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:REDMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-542-8213
Mailing Address - Street 1:PO BOX 9185
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48333-9185
Mailing Address - Country:US
Mailing Address - Phone:734-542-8213
Mailing Address - Fax:734-542-8201
Practice Address - Street 1:888 TERRACE ST
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49440-1220
Practice Address - Country:US
Practice Address - Phone:231-726-5025
Practice Address - Fax:231-728-4958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N28860Medicare ID - Type UnspecifiedMEDICARE PART B - IMMUNIZ