Provider Demographics
NPI:1467755876
Name:VHS DETROIT RECEIVING HOSPITAL INC
Entity Type:Organization
Organization Name:VHS DETROIT RECEIVING HOSPITAL INC
Other - Org Name:DMC PHARMACY DETROIT RECEIVING HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-745-1621
Mailing Address - Street 1:20 BURTON HILLS BLVD STE 100
Mailing Address - Street 2:ATTENTION: CAROL BAILEY
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6409
Mailing Address - Country:US
Mailing Address - Phone:615-665-6000
Mailing Address - Fax:615-665-6184
Practice Address - Street 1:4201 SAINT ANTOINE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2153
Practice Address - Country:US
Practice Address - Phone:313-966-8230
Practice Address - Fax:313-966-8582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-08
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010094763336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6484420001Medicare NSC