Provider Demographics
NPI:1174623870
Name:HOUSE CALL SERVICES LLC
Entity type:Organization
Organization Name:HOUSE CALL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE -PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VESNAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:586-977-2900
Mailing Address - Street 1:8033 E 10 MILE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CENTER LINE
Mailing Address - State:MI
Mailing Address - Zip Code:48015-1427
Mailing Address - Country:US
Mailing Address - Phone:586-977-2900
Mailing Address - Fax:586-977-2992
Practice Address - Street 1:8033 E 10 MILE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CENTER LINE
Practice Address - State:MI
Practice Address - Zip Code:48015-1427
Practice Address - Country:US
Practice Address - Phone:586-977-2900
Practice Address - Fax:586-977-2992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301032630208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3506356272OtherBCBSM
0P30860Medicare PIN