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General NPI Number Information
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NPI Number | 1043385909
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Entity Type | Organization
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Legal Business Name | ASCENSION PROVIDENCE HOSPITAL
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 47601 GRAND RIVER AVE
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City | NOVI
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State | MI
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Zip | 48374-1233
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Country | US
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Telephone | 248-465-4170
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Fax |
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Provider Business Mailing Address
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Address Line | 16001 W 9 MILE RD
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4818
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Country | US
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Telephone | 248-746-3200
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Fax | 248-746-0384
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Authorized Official
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Title or Position | PRESIDENT, VAL BASED ENT & CFO
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Name | ROBIN DAMSCHRODER
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Credential |
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Telephone | 313-876-8452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State | MI
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