Provider Demographics
NPI:1740230648
Name:OAKWOOD HEALTHCARE, INC.
Entity Type:Organization
Organization Name:OAKWOOD HEALTHCARE, INC.
Other - Org Name:BEAUMONT HOSPITAL - TRENTON
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
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 1:5450 FORT ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-4601
Practice Address - Country:US
Practice Address - Phone:734-671-3800
Practice Address - Fax:734-671-3891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI820170282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI49330OtherOMNICARE COVENTRY PROV #
MI6331160OtherAETNA PROV #
MIHL820021OtherM-CARE PROV #
MI301557364Medicaid
MIP00019OtherBCN PROV #
MI405171889Medicaid
230176OtherOSCAR
MI101730OtherCHS/WELLNESS PROV #
MI104666OtherCARE CHOICE PROV #
MI000000001514OtherCAPE HEALTH PROV #
MI00079OtherBCBS PROV #
MI007589OtherMIDWEST HLTH PROV #
MI6331160OtherAETNA PROV #