Provider Demographics
NPI:1417104563
Name:HENRY FORD HOSPITAL
Entity Type:Organization
Organization Name:HENRY FORD HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAMLIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:313-916-1231
Mailing Address - Street 1:2799 W GRAND BLVD
Mailing Address - Street 2:K-1 PHARMACY
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-2608
Mailing Address - Country:US
Mailing Address - Phone:313-916-1231
Mailing Address - Fax:313-916-7444
Practice Address - Street 1:2799 W GRAND BLVD
Practice Address - Street 2:K-1 PHARMACY
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-1231
Practice Address - Fax:313-916-7444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302030609282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital