Provider Demographics
NPI:1386122059
Name:CANCER HEALTH LLC
Entity type:Organization
Organization Name:CANCER HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-632-0003
Mailing Address - Street 1:18600 W 10 MILE RD STE 111
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2645
Mailing Address - Country:US
Mailing Address - Phone:248-632-0003
Mailing Address - Fax:313-736-3340
Practice Address - Street 1:18600 W 10 MILE RD STE 111
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2645
Practice Address - Country:US
Practice Address - Phone:313-736-3340
Practice Address - Fax:313-736-3340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies