Professional Home Care Dearborn Oxygen Therapy Co

Primary specialty

Department of Veterans Affairs (VA) PharmacyTaxonomy code 332100000X

License

5306000370 Issued in MI

Legal business name

PROFESSIONAL HOME CARE DEARBORN OXYGEN THERAPY CO

Practice address

24706 Michigan Ave
Dearborn, MI 48124-1750

Phone

(313) 277-2160

Fax

(313) 277-3079

NPI assigned

Sep 6, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Brian G Kolfage

Title

President

Phone

(313) 277-2160

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326326400000",
    "number": "1720072812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24706 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241750",
            "telephone_number": "313-277-2160",
            "fax_number": "313-277-3079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24706 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241750",
            "telephone_number": "313-277-2160",
            "fax_number": "313-277-3079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL HOME CARE DEARBORN OXYGEN THERAPY CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-06",
        "last_updated": "2012-01-12",
        "status": "A",
        "authorized_official_last_name": "KOLFAGE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-277-2160",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332100000X",
            "taxonomy_group": "",
            "desc": "Department of Veterans Affairs (VA) Pharmacy",
            "state": "MI",
            "license": "5306000370",
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Department of Veterans Affairs (VA) Pharmacy in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Department of Veterans Affairs (VA) Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; 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.