Organization
HENRY FORD HEALTH SYSTEM
Active
Organization
HENRY FORD HEALTH SYSTEM
Active
Other names
Henry Ford Pharmacy Advantage Southfield
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL PAUL KUS (VP OF PHARMACY)
(248) 723-0255
Entity
Organization
Contact information
Practice address
1191 SOUTH BLVD E, ROCHESTER HILLS, MI 48307-5453
(800) 456-2112
(888) 400-0109
Mailing address
30100 TELEGRAPH RD, STE 200, BINGHAM FARMS, MI 48025-4514
(248) 642-1111
(248) 642-6094
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
MI
332BX2000X
Oxygen Equipment & Supplies (DME)
—
MI
333600000X
Pharmacy
5301008716
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301008716
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2043639
PK
—
Enumeration date
01/17/2008
Last updated
04/27/2018
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