Provider Demographics
NPI:1336183367
Name:BOTSFORD GENERAL HOSPITAL
Entity Type:Organization
Organization Name:BOTSFORD GENERAL HOSPITAL
Other - Org Name:BEAUMONT HOSPITAL-FARMINGTON HILLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
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:947-522-3333
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 1:28050 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-5919
Practice Address - Country:US
Practice Address - Phone:947-521-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI00276OtherBLUE CROSS
MI230151OtherALLIANCE HEALTH
MIHL630001OtherMCARE
MI501534OtherCARE CHOICES
MI000000001517OtherCAPE
MI00276OtherBLUE CROSS BLUE SHIELD
MI1555350Medicaid
MI230151OtherHAP
MI5170228Medicaid
B0048OtherBOTSFORD MEDICAL GROUP
MI000000001517OtherCAPE
MI00276OtherBLUE CROSS
MI230151OtherHAP
MI00276OtherBLUE CROSS BLUE SHIELD
MI5170228Medicaid
MI501534OtherCARE CHOICES
0F37181Medicare PIN