| Tuckerville.llc | |
|
35230 E Michigan Ave Wayne MI 48184-3698 | |
| (313) 312-5706 | |
| Not Available |
| Full Name | Tuckerville.llc |
|---|---|
| Speciality | Home Health |
| Location | 35230 E Michigan Ave, Wayne, Michigan |
| Authorized Official Name and Position | Fartima Tucker (CEO/OWNER) |
| Authorized Official Contact | 3133037423 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tuckerville.llc Po Box 125 Belleville MI 48112-0125 Ph: (313) 303-7423 | Tuckerville.llc 35230 E Michigan Ave Wayne MI 48184-3698 Ph: (313) 312-5706 |
| NPI Number | 1063870293 |
|---|---|
| Provider Enumeration Date | 02/02/2016 |
| Last Update Date | 03/24/2023 |
| Certification Date | 03/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063870293 | NPI | - | NPPES |
| 8025368 | Medicaid | MI | |
| 1437626454 | Other | MI | TUCKERVILLE, LLC |
| 1396097457 | Other | MI | NPI |
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