Healthcare Provider Details

I. General information

NPI: 1093744153
Provider Name (Legal Business Name): WILLIAM BEAUMONT HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31157 WOODWARD AVE STE 101
ROYAL OAK MI
48073-0996
US

IV. Provider business mailing address

26901 BEAUMONT BLVD BLDG D6
SOUTHFIELD MI
48033-3849
US

V. Phone/Fax

Practice location:
  • Phone: 947-523-4900
  • Fax:
Mailing address:
  • Phone: 947-522-1963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW E COX
Title or Position: CHIEF FINANCIAL OFFICER,
Credential:
Phone: 616-486-5246