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General NPI Number Information
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NPI Number | 1730324187
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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 | 12/12/2008
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Last Update Date | 12/02/2016
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Provider Practice Location Address
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Address Line | 6530 FARMINGTON RD
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-3216
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Country | US
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Telephone | 248-661-5333
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Fax | 248-661-5418
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Provider Business Mailing Address
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Address Line | 30100 TELEGRAPH RD STE 200
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City | BINGHAM FARMS
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State | MI
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Zip | 48025-4514
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Country | US
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Telephone | 248-642-1111
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Fax | 248-642-6094
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Authorized Official
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Title or Position | VP AMBULATORY PHARMACY
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Name | DANIEL KUS
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Credential | RPH
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301008976
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License Number State | MI
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