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General NPI Number Information
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NPI Number | 1588654321
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Entity Type | Organization
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Legal Business Name | HENRY FORD HEALTH SYSTEM
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Dates
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Enumeration Date | 10/24/2005
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Last Update Date | 09/10/2010
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Provider Practice Location Address
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Address Line | 21651 MELROSE AVE
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City | SOUTHFIELD
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State | MI
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Zip | 48075-7906
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Country | US
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Telephone | 248-353-2468
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Fax | 248-353-4260
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Provider Business Mailing Address
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Address Line | 21651 MELROSE AVE
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City | SOUTHFIELD
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State | MI
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Zip | 48075-7906
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Country | US
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Telephone | 248-353-2468
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Fax | 248-353-4260
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. JOHN POLANSKI
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Credential |
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Telephone | 248-642-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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