Provider Demographics
NPI:1720517113
Name:THERAMEDIC HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:THERAMEDIC HOME HEALTH CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PANKAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:MAMTORA
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:248-565-4000
Mailing Address - Street 1:26400 W 12 MILE RD STE 80
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1700
Mailing Address - Country:US
Mailing Address - Phone:248-565-4000
Mailing Address - Fax:248-565-4020
Practice Address - Street 1:26400 W. 12 MILE RD
Practice Address - Street 2:SUITE 80
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034
Practice Address - Country:US
Practice Address - Phone:248-565-4000
Practice Address - Fax:248-565-4020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health