Provider Demographics
NPI:1043549439
Name:WILLIAM BEAUMONT HOSPITAL
Entity Type:Organization
Organization Name:WILLIAM BEAUMONT HOSPITAL
Other - Org Name:BEAUMONT HOSPITAL - TROY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:SUSICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:947-522-3338
Mailing Address - Street 1:26901 BEAUMONT BLVD BLDG D-6
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1963
Mailing Address - Fax:
Practice Address - Street 1:44201 DEQUINDRE RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085
Practice Address - Country:US
Practice Address - Phone:248-964-3681
Practice Address - Fax:248-964-3682
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLIAM BEAUMONT HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-14
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy