Healthcare Provider Details

I. General information

NPI: 1437600103
Provider Name (Legal Business Name): WILLIAM BEAUMONT HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2016
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41965 ECORSE RD STE COREWELL
VAN BUREN TWP MI
48111-1164
US

IV. Provider business mailing address

41965 ECORSE RD STE 100
VAN BUREN TWP MI
48111-1164
US

V. Phone/Fax

Practice location:
  • Phone: 586-753-4180
  • Fax:
Mailing address:
  • Phone: 586-753-4180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

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