# BEAUMONT WEST BLOOMFIELD ASC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982802203
- **Authorized official:** MR. JOHN T FOX (CEO)
- **Authorized official phone:** (248) 213-3334

## Contact information

- **Practice address:** 6900 ORCHARD LAKE ROAD, SUITE LL100, WEST BLOOMFIELD, MI 48322
- **Practice address phone:** (248) 406-2400
- **Practice address fax:** (248) 406-2401
- **Mailing address:** 6900 ORCHARD LAKE ROAD, SUITE LL100, WEST BLOOMFIELD, MI 48322
- **Mailing address phone:** (248) 406-2400
- **Mailing address fax:** (248) 406-2401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 1010000081 | MI | Yes |

## Other

- **Enumeration date:** 07/08/2007
- **Last updated:** 12/21/2015