MEDICARE: HENRY FORD HEALTH SYSTEM

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	273Y00000X	Rehabilitation Hospital Unit	82-0040	MI

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	266564000	OTHER	MI	E20 COMM BEHAVIOR
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	49882	OTHER	MI	H45 OMNICARE
4	0726021	OTHER	MI	H71 AETNA HMO
5	341420303	OTHER	MI	J23 MEADOWBROOK
6	383404533002	OTHER	MI	G03 TRICARE
7	369003700	OTHER	MI	J52 US DEPT/LABOR
8	000000001537	OTHER	MI	E04 CAPE HEALTH
9	010900	OTHER	MI	E21 CARELINK NETWO
10	121143	OTHER	MI	H08 CARE CHOICES HMO
11	383404533002	OTHER	MI	G02 CHAMPVA CENTER
12	121143	OTHER	MI	H50 PREFERRED CHOI
13	383404533002	OTHER	MI	G01 TRI-CARE
14	55150	OTHER	MI	H61 TOTAL HLTH CAR
15	14599	OTHER	MI	E22 PERSON CENTER

NPI Number	:	1336235498
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HENRY FORD HEALTH SYSTEM

Provider Business Mailing Address
First Line	:	1 FORD PL
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48202-3450
Country	:	US
Telephone Number	:	586-498-4960
Fax Number	:	586-498-4936

Provider Business Practice Location Address
First Line	:	44800 DELCO BLVD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48313-1026
Country	:	US
Telephone Number	:	586-726-6400
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	JAMES CONNELLY
Credential	:
Telephone Number	:	313-876-8714

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	03/17/2011