Provider Demographics
NPI:1972762938
Name:SAV ON HOME HEALTHCARE SUPPLY INC
Entity type:Organization
Organization Name:SAV ON HOME HEALTHCARE SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT - PHARMACY OPERATION
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:MAC
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:734-377-3154
Mailing Address - Street 1:34550 GLENDALE ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1304
Mailing Address - Country:US
Mailing Address - Phone:734-525-1700
Mailing Address - Fax:734-525-1808
Practice Address - Street 1:43500 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-2436
Practice Address - Country:US
Practice Address - Phone:586-739-1450
Practice Address - Fax:586-739-0325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301006100332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4838930Medicaid
MI2353427OtherNCPDP IDENTIFICATION NUMBER
MI5301006100OtherMICHIGAN PHARMACY LICENSE
MI540E008030OtherBLUE CROSS BLUE SHIELD MICHIGAN DME PROVIDER
MIBW4109092OtherDEA REGISTRATION
MI540E008030OtherBLUE CROSS BLUE SHIELD MICHIGAN DME PROVIDER