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General NPI Number Information
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NPI Number | 1841398823
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Entity Type | Organization
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Legal Business Name | HENRY FORD MACOMB HOSPITAL CORPORATION
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 12/05/2016
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Provider Practice Location Address
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Address Line | 30795 23 MILE RD
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City | CHESTERFIELD
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State | MI
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Zip | 48047-5720
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Country | US
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Telephone | 586-421-3020
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Fax | 586-421-3021
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Provider Business Mailing Address
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Address Line | 30795 23 MILE RD
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City | CHESTERFIELD
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State | MI
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Zip | 48047-5720
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Country | US
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Telephone | 586-421-3020
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Fax | 586-421-3021
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Authorized Official
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Title or Position | VP PHARMACY OPERATIONS
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Name | DANIEL 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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301007383
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License Number State | MI
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