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NPI Code Detail

MEDICARE: FOREST HEALTH MEDICAL CENTER LLC

MEDICARE: FOREST HEALTH MEDICAL CENTER LLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0004XCompounding Pharmacy
33336I0012XInstitutional Pharmacy5301007213MI
43336S0011XSpecialty Pharmacy
5282N00000XGeneral Acute Care Hospital

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12135339OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669493664
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOREST HEALTH MEDICAL CENTER LLC
Provider Business Mailing Address
First Line : 135 S PROSPECT ST
Second Line :
City : YPSILANTI
State : MI
Zip : 48198-7914
Country : US
Telephone Number : 734-547-4721
Fax Number :
Provider Business Practice Location Address
First Line : 135 S PROSPECT ST
Second Line :
City : YPSILANTI
State : MI
Zip : 48198-7914
Country : US
Telephone Number : 734-547-4722
Fax Number : 734-547-1461
Authorized Official
Title or Position : PRESIDENT
Name : EJ LEDESMA
Credential :
Telephone Number : 734-547-1410
Provider Enumeration Date : 07/22/2006
Last Update Date : 10/22/2018

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Directions to “FOREST HEALTH MEDICAL CENTER LLC ” Practice Location

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