MEDICARE: HENRY FORD MACOMB HOSPITAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	230204	OTHER	MI	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902842735
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HENRY FORD MACOMB HOSPITAL CORPORATION

Provider Business Mailing Address
First Line	:	13355 E 10 MILE RD
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48089-2048
Country	:	US
Telephone Number	:	313-874-4633
Fax Number	:	313-847-3943

Provider Business Practice Location Address
First Line	:	13355 EAST 10 MILE RD
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48089-2048
Country	:	US
Telephone Number	:	313-874-4633
Fax Number	:	313-847-3943

Authorized Official
Title or Position	:	SR. VICE PRESIDENT
Name	:	MR. JAMES M CONNELLY
Credential	:
Telephone Number	:	313-874-8714

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	01/12/2011

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Directions to “HENRY FORD MACOMB HOSPITAL CORPORATION ” Practice Location

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