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General NPI Number Information
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NPI Number | 1861861965
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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 | 09/18/2015
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Last Update Date | 09/18/2015
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Provider Practice Location Address
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Address Line | 6777 W MAPLE RD
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-3013
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Country | US
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Telephone | 248-325-3820
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Fax |
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Provider Business Mailing Address
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Address Line | 6777 W MAPLE RD
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-3013
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Country | US
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Telephone | 248-325-3820
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | VANESSA JAMIL
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Credential |
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Telephone | 248-807-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 5302041048
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License Number State | MI
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