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General NPI Number Information
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NPI Number | 1962586123
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Entity Type | Organization
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Legal Business Name | W.A. FOOTE MEMORIAL HOSPITAL, INC.
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 205 N EAST AVE ONE JACKSON SQUARE, SUITE 400
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City | JACKSON
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State | MI
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Zip | 49201-1753
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Country | US
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Telephone | 517-841-6982
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Fax | 517-841-6987
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Provider Business Mailing Address
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Address Line | 1 FORD PL STE 2E
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City | DETROIT
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State | MI
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Zip | 48202-3450
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Country | US
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Telephone | 313-874-4806
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Fax | 313-876-1305
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Authorized Official
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Title or Position | PRESIDENT, VAL BASED ENT & CFO
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Name | ROBIN DAMSCHRODER
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Credential |
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Telephone | 313-876-8452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 380010
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License Number State | MI
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