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General NPI Number Information
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NPI Number | 1558429670
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Entity Type | Organization
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Legal Business Name | HENRY FORD WYANDOTTE HOSPITAL
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 12/05/2016
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Provider Practice Location Address
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Address Line | 2333 BIDDLE AVE
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City | WYANDOTTE
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State | MI
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Zip | 48192-4668
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Country | US
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Telephone | 734-246-9499
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Fax | 734-246-6961
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Provider Business Mailing Address
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Address Line | 2333 BIDDLE AVE
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City | WYANDOTTE
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State | MI
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Zip | 48192-4668
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Country | US
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Telephone | 734-246-9499
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Fax | 734-246-6961
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Authorized Official
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Title or Position | VP OF PHARMACY
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Name | DAN KUS
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Credential | RPH
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Telephone | 248-723-0255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | 5301004788
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License Number State | MI
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