# ASCENSION PROVIDENCE HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PH Emergency Medcine/Providence Hosptial and Medical Centers Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922061167
- **Authorized official:** SARAH STARKEL (SUPERVISOR, ENROLLMENT)
- **Authorized official phone:** (248) 680-8121

## Contact information

- **Practice address:** 16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
- **Practice address phone:** (248) 849-3000
- **Practice address fax:** (248) 849-2244
- **Mailing address:** 3168 SOLUTIONS CENTER BOX 773168, CHICAGO, IL 60677-0001
- **Mailing address phone:** (248) 680-8000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | NULL | Yes |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/10/2006
- **Last updated:** 11/15/2023