Healthcare Provider Details

I. General information

NPI: 1073821385
Provider Name (Legal Business Name): VHS CHILDRENS HOSPITAL OF MICHIGAN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2010
Last Update Date: 03/22/2022
Certification Date: 03/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 BEAUBIEN ST ROOM 108
DETROIT MI
48201-2119
US

IV. Provider business mailing address

20 BURTON HILLS BLVD STE 100 ATTENTION: CAROL BAILEY
NASHVILLE TN
37215-6409
US

V. Phone/Fax

Practice location:
  • Phone: 313-745-0436
  • Fax: 313-745-1170
Mailing address:
  • Phone: 313-745-0436
  • Fax: 615-665-6184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number5301009484
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301009484
License Number StateMI

VIII. Authorized Official

Name: LINSDAY JOSEPH
Title or Position: CFO
Credential:
Phone: 313-745-5437