Home Clinic PC

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

HOME CLINIC PC

Doing business as

Great Lakes Physicians of Southfield, LLC

Practice address

23999 Northwestern Hwy
Southfield, MI 48075-2578

Phone

(248) 223-1500

NPI assigned

Mar 31, 2010

Last updated

Mar 7, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

HOME CLINIC PCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Paul Petre, MD

Title

Owner

Phone

(248) 223-1500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Great Lakes Physicians of Southfield, LLC Doing business as

Part of

Home Clinic PC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Home Clinic PC

  • General Practice Physician
  • Southfield, MI
  • NPI 1962645689
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299456000000",
    "number": "1710202825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 N BEVERLY GLEN CIR",
            "address_2": "STE 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23999 NORTHWESTERN HWY",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752578",
            "telephone_number": "248-223-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME CLINIC PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOME CLINIC PC",
        "enumeration_date": "2010-03-31",
        "last_updated": "2011-03-07",
        "status": "A",
        "authorized_official_last_name": "PETRE",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-223-1500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "MI1676",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Lakes Physicians of Southfield, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health of America Inc
• Home Help and Care Inc
• Home Help Assistance, Inc

• Non-Pharmacy Dispensing Site in Southfield, MI
• Providers in Southfield, MI by specialty
• Non-Pharmacy Dispensing Site in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.