Provider Demographics
NPI:1578849329
Name:HENRY FORD WEST BLOOMFIELD HOSPITAL
Entity Type:Organization
Organization Name:HENRY FORD WEST BLOOMFIELD HOSPITAL
Other - Org Name:HENRY FORD WEST BLOOMFIELD-CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHMITT
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:313-874-4920
Mailing Address - Street 1:6777 W. MAPLE ROAD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3013
Mailing Address - Country:US
Mailing Address - Phone:248-661-4100
Mailing Address - Fax:248-325-3830
Practice Address - Street 1:6777 W. MAPLE
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3013
Practice Address - Country:US
Practice Address - Phone:248-661-4100
Practice Address - Fax:248-325-3830
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HENRY FORD WEST BLOOMFIELD HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-25
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty