PROFESSIONAL HOME CARE DEARBORN OXYGEN THERAPY CO (NPI# 1720072812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720072812 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL HOME CARE DEARBORN OXYGEN THERAPY CO |
| Practice Address |
24706 Michigan Ave Dearborn MI 48124-1750 |
| Practice Telephone | 3132772160 |
| Practice Fax Number | 3132773079 |
| Mailing Telephone | 3132772160 |
| Mailing Fax Number | 3132773079 |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2012-01-12 |
| Authorized Official Name | MR. BRIAN G KOLFAGE (PRESIDENT) |
| Authorized Official Telephone | 3132772160 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
Suppliers | ||
| Y | 332100000X | Department of Veterans Affairs (VA) Pharmacy | 5306000370 | MI | Suppliers |
| Street Address |
24706 MICHIGAN AVE |
| City | DEARBORN |
| State | MI |
| Zip Code | 48124-1750 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629685797 | Pharma Rx Services LLC | Pharmacy | 24706 Michigan Ave, Dearborn, MI 48124-1750 | 2020-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396389524 | Pharma A, LLC | Pharmacy | 23916 Michigan Ave, Dearborn, MI 48124 | 2019-10-31 |
| 1225683725 | Aysha Said | Behavior Technician | 1369 Porter St, Dearborn, MI 48124 | 2019-08-02 |
| 1881257772 | Leen Nusairat | Internal Medicine | Beaumont Health-dearborn Campus, 18101 Oakwood Blvd, Dearborn, MI 48124 | 2019-04-17 |
| 1417413360 | Gary C. Veraghen, Dds, PC | Dentist | 22100 W. Outer Drive, Dearborn, MI 48124 | 2019-02-15 |
| 1982168787 | Fnu Asma Manzar | Physical Therapist | Global Physical Therapy Services, Inc, 22819 Michigan Avenue, Dearborn, MI 48124 | 2019-01-25 |
| 1639640162 | Jernia Lashawn Usher | Behavior Technician | 1360 Porter St Lower Level, Dearborn, MI 48124 | 2018-12-10 |
| 1710456470 | Samar Fouad Hannawi | Psychologist | 3815 Pelham Street, Suite #13, Dearborn, MI 48124 | 2018-11-24 |
| 1881178747 | Sarah Chehab | Psychologist | 835 Mason St Suite 220b, Dearborn, MI 48124 | 2018-09-17 |
| 1568948289 | Ibrahim M Basma | Pharmacist | 22521 Michigan Avenue, Dearborn, MI 48124 | 2018-07-16 |
| 1669961942 | Jacqueline E Domzalski | Technician, Other | 3231 S. Gulley, Suite E, Dearborn, MI 48124 | 2018-05-02 |
| Find all providers in zip 48124 | ||||
| Taxonomy Code | 332100000X |
| Grouping | Suppliers |
| Classification | Department of Veterans Affairs (VA) Pharmacy |
| Department of Veterans Affairs (VA) Pharmacy means any place under VA jurisdiction where drugs are dispensed and Pharmaceutical Care is provided to enrolled Veterans, by licensed pharmacists. The Pharmacy is reviewed by JCAHO, utilizes the VA hospital’s DEA number, and has a designated NCPDP number. VA facility pharmacies include Inpatient (Institutional), Outpatient, Consolidated Mail Outpatient Pharmacies (CMOPs), Research, Addiction Treatment Centers, Long Term Care and Community Based Outpatient Clinics Pharmacies. The VHA Pharmacy Benefits Management - Strategic Healthcare Group has oversight for professional and practice activities of VA Pharmacies. Each pharmacy is under the direct supervision of a U.S. or U.S. territory licensed pharmacist, and has staffing to meet its designated scope of service. |
| Notes: Source: Pharmacy Benefits Management – Strategic Healthcare Group, Veterans Health Administration, Department of Veterans Affairs [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881642858 | Battle Creek Vamc | Department of Veterans Affairs (VA) Pharmacy | 5838 Metro Way Sw, Wyoming, MI 49519 | 2006-05-04 |
| 1043820798 | Timothy David Brietzke | Department of Veterans Affairs (VA) Pharmacy | 1500 Weiss St, Saginaw, MI 48602-5251 | 2020-08-07 |
| 1093345282 | Lisa Marie Wehr | Department of Veterans Affairs (VA) Pharmacy | 2215 Fuller Rd, Ann Arbor, MI 48105-2303 | 2020-01-16 |
| 1326006867 | Saginaw Vamc | Department of Veterans Affairs (VA) Pharmacy | 1500 Weiss St, Saginaw, MI 48602-5251 | 2006-05-03 |
| 1184682007 | Detroit Vamc | Department of Veterans Affairs (VA) Pharmacy | 4646 John R St, Detroit, MI 48201-1916 | 2006-05-02 |
| 1528026333 | Iron Mountain Vamc | Department of Veterans Affairs (VA) Pharmacy | 325 E H St, Iron Mountain, MI 49801-4760 | 2006-05-02 |
| 1700843836 | Battle Creek Vamc | Department of Veterans Affairs (VA) Pharmacy | 5500 Armstrong Rd, Battle Creek, MI 49037-7314 | 2006-05-01 |
| 1821055906 | Ann Arbor Vamc | Department of Veterans Affairs (VA) Pharmacy | 2215 Fuller Rd, Ann Arbor, MI 48105-2303 | 2006-05-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.