Healthcare Provider Details

I. General information

NPI: 1760600241
Provider Name (Legal Business Name): HENRY FORD HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24445 NORTHWESTERN HWY STE 109
SOUTHFIELD MI
48075-2436
US

IV. Provider business mailing address

24445 NORTHWESTERN HWY STE 109
SOUTHFIELD MI
48075-2436
US

V. Phone/Fax

Practice location:
  • Phone: 248-355-6400
  • Fax: 313-874-6501
Mailing address:
  • Phone: 248-355-6400
  • Fax: 313-874-6501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateMI

VIII. Authorized Official

Name: MR. MICHAEL S ELLIS
Title or Position: VICE PRESIDENT
Credential: RN
Phone: 313-874-6500