Provider Demographics
NPI:1730349861
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 1:11912 WHITMORE LAKE RD
Practice Address - Street 2:
Practice Address - City:WHITMORE LAKE
Practice Address - State:MI
Practice Address - Zip Code:48189-9372
Practice Address - Country:US
Practice Address - Phone:734-449-0004
Practice Address - Fax:734-449-0403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301007387332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4838986Medicaid
MI2345696OtherNCPDP IDENTIFICATION NUMBER
MI5301007387OtherMICHIGAN PHARMACY LICENSE
MI540H104230OtherBLUE CROSS BLUE SHIELD MICHIGAN DME PROVIDER ID
MI540H104230OtherBLUE CROSS BLUE SHIELD MICHIGAN DME PROVIDER ID
MI4221530014Medicare NSC