| Providence Homecare Providers Pllc | |
|
25511 Southfield Rd Ste 118 Southfield MI 48075-1830 | |
| (248) 443-6690 | |
| (248) 443-6692 |
| Full Name | Providence Homecare Providers Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 25511 Southfield Rd Ste 118, Southfield, Michigan |
| Authorized Official Name and Position | Josephina Cabuena Bello (PRESIDENT) |
| Authorized Official Contact | 7342603137 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Homecare Providers Pllc 25511 Southfield Rd Ste 118 Southfield MI 48075-1830 Ph: (248) 443-6690 | Providence Homecare Providers Pllc 25511 Southfield Rd Ste 118 Southfield MI 48075-1830 Ph: (248) 443-6690 |
| NPI Number | 1174031942 |
|---|---|
| Provider Enumeration Date | 01/16/2018 |
| Last Update Date | 01/16/2018 |
| Medicare PECOS PAC ID | 4587926324 |
|---|---|
| Medicare Enrollment ID | O20180315000308 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174031942 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Josephine C Bello |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457455503 PECOS PAC ID: 1456337138 Enrollment ID: I20041007000546 |
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