Provider Demographics
NPI:1598337602
Name:HENRY FORD HEALTH SYSTEM
Entity Type:Organization
Organization Name:HENRY FORD HEALTH SYSTEM
Other - Org Name:HENRY FORD HEALTH SYSTEM MOBILE INTEGRATED HEALTH SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PROVIDER AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:RATOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-703-2003
Mailing Address - Street 1:1 FORD PL STE 4F
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3450
Mailing Address - Country:US
Mailing Address - Phone:313-300-8355
Mailing Address - Fax:313-876-1305
Practice Address - Street 1:1 FORD PL STE 3A
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3450
Practice Address - Country:US
Practice Address - Phone:313-874-4806
Practice Address - Fax:313-876-1305
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HENR Y FORD HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-16
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No282N00000XHospitalsGeneral Acute Care HospitalGroup - Multi-Specialty