Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 332B00000X | Durable Medical Equipment & Medical Supplies | | | | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 0435520001 | OTHER | MICHIGAN | ABP ADMINISTRATION |
| 2 | 540G40258 | OTHER | MICHIGAN | BLUE CROSS MASTER MEDICAL |
| 3 | 608 | OTHER | MICHIGAN | NORTHWOOD AAA-PAR PROVIDE |
| 4 | 1825492 | MEDICAID | MICHIGAN | |
| 5 | ABLE6277-001 | OTHER | MICHIGAN | LINKIA, LLC |
| 6 | 0435520001 | OTHER | MICHIGAN | MEDICARE DMERC A,B,C |
| 7 | 1825492 | OTHER | MICHIGAN | HEALTH ALLIANCE PLAN |
| 8 | 52562 | OTHER | MICHIGAN | NORTHWOOD NPN-PAR PROVIDE |
| 9 | 0983934 | OTHER | MICHIGAN | HEALTHPLUS OF MICHIGAN |
| 10 | 510654 | OTHER | MICHIGAN | CARE CHOICES HMO |
| 11 | 540G40258 | OTHER | MICHIGAN | BCBS MI FED. EMPLOYEE PRO |
| 12 | 540G40258 | OTHER | MICHIGAN | BLUE CARE NETWORK |
| 13 | 540G40258 | OTHER | MICHIGAN | BLUE CROSS BLUE SHIELD MI |
| 14 | 630050 | OTHER | MICHIGAN | MCARE |
| 15 | 5929050 | OTHER | MICHIGAN | CIGNA HEALTH CARE |
| 16 | QMXPR0009327 | OTHER | MICHIGAN | MOLINA HEALTH CARE OF MI |