Provider Demographics
NPI:1740230119
Name:OAKWOOD HEALTHCARE, INC.
Entity Type:Organization
Organization Name:OAKWOOD HEALTHCARE, INC.
Other - Org Name:BEAUMONT HOSPITAL - DEARBORN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:SUSICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:947-522-3338
Mailing Address - Street 1:26901 BEAUMONT BLVD BLDG D-6
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1963
Mailing Address - Fax:
Practice Address - Street 1:18101 OAKWOOD BLVD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-4089
Practice Address - Country:US
Practice Address - Phone:313-593-7000
Practice Address - Fax:313-436-2038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI820120282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI405171566Medicaid
MIP00205OtherBCN PROV #
230020OtherOSCAR
MIHL820013OtherM-CARE PROV #
MI118626OtherGREAT LAKES HLTH PROV #
MI000000001513OtherCAPE HEALTH PROV #
MI00205OtherBCBS PROV #
MI101520OtherCHS/WELLNESS PROV #
MI301556803Medicaid
MI006403OtherMIDWEST HLTH PROV #
MI40205OtherBCBS SPRINGWELLS PROV #
MI104641OtherCARE CHOICE
MI49342OtherOMNICARE COVENTRY PROV #
MI6330275OtherAETNA PROV #
MI40205OtherBCBS SPRINGWELLS PROV #