Provider Demographics
NPI:1194098301
Name:PRESTIGE HOME HEALTH CARE INC
Entity type:Organization
Organization Name:PRESTIGE HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ABID
Authorized Official - Middle Name:FAYYAZ
Authorized Official - Last Name:CHAUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-871-3009
Mailing Address - Street 1:17520 W 12 MILE RD
Mailing Address - Street 2:SUITE # 212
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-1945
Mailing Address - Country:US
Mailing Address - Phone:586-871-3009
Mailing Address - Fax:586-843-3396
Practice Address - Street 1:17520 W 12 MILE RD
Practice Address - Street 2:SUITE # 212
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-1945
Practice Address - Country:US
Practice Address - Phone:586-871-3009
Practice Address - Fax:586-843-3396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-17
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization