1336235498 NPI number — HENRY FORD HEALTH SYSTEM

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336235498 NPI number — HENRY FORD HEALTH SYSTEM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HENRY FORD HEALTH SYSTEM
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336235498
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/17/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 FORD PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DETROIT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48202-3450
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
586-498-4960
Provider Business Mailing Address Fax Number:
586-498-4936

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
44800 DELCO BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STERLING HEIGHTS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48313-1026
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-726-6400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CONNELLY
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
313-876-8714

Provider Taxonomy Codes

  • Taxonomy code: 273Y00000X , with the licence number:  82-0040 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 266564000 . This is a "E20 COMM BEHAVIOR" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 40 5170433 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 49882 . This is a "H45 OMNICARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0726021 . This is a "H71 AETNA HMO" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 341420303 . This is a "J23 MEADOWBROOK" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 383404533002 . This is a "G03 TRICARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 369003700 . This is a "J52 US DEPT/LABOR" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 000000001537 . This is a "E04 CAPE HEALTH" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 010900 . This is a "E21 CARELINK NETWO" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 121143 . This is a "H08 CARE CHOICES HMO" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 383404533002 . This is a "G02 CHAMPVA CENTER" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 121143 . This is a "H50 PREFERRED CHOI" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 383404533002 . This is a "G01 TRI-CARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 55150 . This is a "H61 TOTAL HLTH CAR" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 14599 . This is a "E22 PERSON CENTER" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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