Provider Demographics
NPI:1295036374
Name:ST JOSEPH MERCY OAKLAND
Entity Type:Organization
Organization Name:ST JOSEPH MERCY OAKLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:248-635-9878
Mailing Address - Street 1:1436 LILA DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-3407
Mailing Address - Country:US
Mailing Address - Phone:248-635-9878
Mailing Address - Fax:
Practice Address - Street 1:1436 LILA DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-3407
Practice Address - Country:US
Practice Address - Phone:248-635-9878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704222106282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital