Provider Demographics
NPI:1447357470
Name:MITCHELL HOME MEDICAL INC.
Entity type:Organization
Organization Name:MITCHELL HOME MEDICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:W
Authorized Official - Last Name:MICHALUK
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:734-572-0203
Mailing Address - Street 1:3810 PACKARD ST STE 200A
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-2054
Mailing Address - Country:US
Mailing Address - Phone:734-572-0203
Mailing Address - Fax:734-749-1351
Practice Address - Street 1:3810 PACKARD ST STE 100B
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-2054
Practice Address - Country:US
Practice Address - Phone:734-477-0202
Practice Address - Fax:734-749-1351
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANN ARBOR WELDING SUPPLY CO., INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-20
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
3944540001Medicare NSC