Provider Demographics
NPI:1699280586
Name:REMEDI SENIORCARE OF MICHIGAN, LLC
Entity type:Organization
Organization Name:REMEDI SENIORCARE OF MICHIGAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRONFEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-927-8403
Mailing Address - Street 1:1 OLYMPIC PL STE 600
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-4110
Mailing Address - Country:US
Mailing Address - Phone:443-632-1208
Mailing Address - Fax:
Practice Address - Street 1:14700 HELM CT
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-6062
Practice Address - Country:US
Practice Address - Phone:833-754-1260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-13
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy