Provider Demographics
NPI:1891021135
Name:WILLIAM BEAUMONT HOSPITALS
Entity Type:Organization
Organization Name:WILLIAM BEAUMONT HOSPITALS
Other - Org Name:BEAUMONT HOME INFUSION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER, CHE
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:E
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:047-522-3333
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 1:31157 WOODWARD AVE STE 101
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-0996
Practice Address - Country:US
Practice Address - Phone:248-743-6500
Practice Address - Fax:248-743-6530
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLIAM BEAUMONT HOSPITALS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-21
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI94-0F36197-0OtherBCBSM HEMOPHILIA
MI94-0F36197-0OtherBCBS HEMOPHILIA