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NPI Code Detail

MEDICARE: W.A. FOOTE MEMORIAL HOSPITAL

MEDICARE: W.A. FOOTE MEMORIAL HOSPITAL
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
1251E00000XHome Health Agency380010MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2OE122OTHERMIBLUE CROSS OF MICHIGAN
360-20013OTHERMIPHYSICIAN'S HEALTH PLAN
42859OTHERMIHEALTH PLAN OF MICHIGAN

General Provider Information

NPI Number : 1962586123
Entity Type Code : Organization
Provider Name (Legal Business Name) : W.A. FOOTE MEMORIAL HOSPITAL
Provider Business Mailing Address
First Line : 1 FORD PL STE 2E
Second Line :
City : DETROIT
State : MI
Zip : 48202-3450
Country : US
Telephone Number : 313-874-4806
Fax Number : 313-876-1305
Provider Business Practice Location Address
First Line : 205 N EAST AVE
Second Line : ONE JACKSON SQUARE, SUITE 400
City : JACKSON
State : MI
Zip : 49201-1753
Country : US
Telephone Number : 517-841-6982
Fax Number : 517-841-6987
Authorized Official
Title or Position : PRESIDENT, VAL BASED ENT & CFO
Name : ROBIN DAMSCHRODER
Credential :
Telephone Number : 313-876-8452
Provider Enumeration Date : 10/24/2006
Last Update Date : 01/07/2026

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