Provider Demographics
NPI:1518987908
Name:HENRY FORD HEALTH SYSTEM
Entity Type:Organization
Organization Name:HENRY FORD HEALTH SYSTEM
Other - Org Name:GREENFIELD HEALTH SYSTEMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:F
Authorized Official - Last Name:SHEPHERD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-642-5038
Mailing Address - Street 1:30100 TELEGRAPH RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4516
Mailing Address - Country:US
Mailing Address - Phone:248-723-0224
Mailing Address - Fax:248-642-7852
Practice Address - Street 1:24565 HAIG ST
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-3322
Practice Address - Country:US
Practice Address - Phone:313-291-7800
Practice Address - Fax:313-291-7420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
14645OtherMCARE
43430OtherGREATLAKES
4808EOtherCAPE
501076OtherULTI MED
123051OtherPREFERRED CHOICE
P08916OtherBLUE CARE NETWORK
08916OtherFEDERAL BLUE CROSS PRIMAR
123051OtherCARE CHOICES
232505OtherHAP
08916OtherBLUE CROSS PRIMARY
09402OtherBLUE CROSS SECONDARY
09402OtherFEDERAL BLUE CROSS SECOND
1022510001OtherWELLNESS
8463770OtherAETNA
MI2610448Medicaid
123051OtherPREFERRED CHOICE