Healthcare Provider Details

I. General information

NPI: 1164746251
Provider Name (Legal Business Name): HENRY FORD HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2010
Last Update Date: 03/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 W GRAND BLVD
DETROIT MI
48202-2608
US

IV. Provider business mailing address

2799 W GRAND BLVD
DETROIT MI
48202-2608
US

V. Phone/Fax

Practice location:
  • Phone: 313-916-5445
  • Fax: 313-916-4353
Mailing address:
  • Phone: 313-916-5445
  • Fax: 313-916-4353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number4704183852
License Number StateMI

VIII. Authorized Official

Name: MS. MARIANNE BEACH-LANGLOIS
Title or Position: ADMINISTRATOR TRANSPLANT INSTITUTE
Credential: MSA
Phone: 313-916-5445