Healthcare Provider Details

I. General information

NPI: 1356384697
Provider Name (Legal Business Name): WILLIAM BEAUMONT HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 W 13 MILE RD PHARMACY
ROYAL OAK MI
48073-6712
US

IV. Provider business mailing address

26901 BEAUMONT BLVD BLDG D-6
SOUTHFIELD MI
48033-3849
US

V. Phone/Fax

Practice location:
  • Phone: 248-898-4098
  • Fax: 248-721-9660
Mailing address:
  • Phone: 947-522-1963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number5301001594
License Number StateMI

VIII. Authorized Official

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