Organization
BEDSIDE MANNERS HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TANAQUIL POWERS (ADMINISTRATOR)
(313) 879-9301
Entity
Organization
Contact information
Practice address
21650 W 11 MILE RD, STE 207A, SOUTHFIELD, MI 48075-2851
(313) 879-9301
(855) 516-8881
Mailing address
PO BOX 37523, OAK PARK, MI 48237-0523
(313) 879-9301
(855) 516-8881
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H257080
BCBS
MI
05
—
1669709416
—
MI
Enumeration date
11/13/2009
Last updated
03/14/2017
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