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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