Provider Demographics
NPI:1144253956
Name:MEDLIFE HOME CARE INC
Entity type:Organization
Organization Name:MEDLIFE HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PRIYANKA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-216-6032
Mailing Address - Street 1:33611 WARREN RD STE A
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-2787
Mailing Address - Country:US
Mailing Address - Phone:248-216-6032
Mailing Address - Fax:734-987-1107
Practice Address - Street 1:33611 WARREN RD STE A
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-2787
Practice Address - Country:US
Practice Address - Phone:248-216-6032
Practice Address - Fax:734-987-1107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
237718Medicare Oscar/Certification