Provider Demographics
NPI: | 1477040343 |
---|---|
Name: | IHA HEALTH SERVICES CORPORATION |
Entity type: | Organization |
Organization Name: | IHA HEALTH SERVICES CORPORATION |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT & CHIEF OPERATING OFFICER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CYNTHIA |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | ELLIOTT |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 734-327-0872 |
Mailing Address - Street 1: | 24 FRANK LLOYD WRIGHT DR LBBY J2000 |
Mailing Address - Street 2: | |
Mailing Address - City: | ANN ARBOR |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48105-9484 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 14650 E OLD US HIGHWAY 12 STE 105 |
Practice Address - Street 2: | |
Practice Address - City: | CHELSEA |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48118-1808 |
Practice Address - Country: | US |
Practice Address - Phone: | 734-593-5700 |
Practice Address - Fax: | 734-593-5705 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-04-17 |
Last Update Date: | 2018-04-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty |