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Organization

HENRY FORD HEALTH SYSTEM

Active
Other names
Henry Ford Home Infusion
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL S. ELLIS RN (VICE PRESIDENT)
(313) 874-6549
Entity
Organization

Contact information

Practice address
21298 MELROSE AVE, SOUTHFIELD, MI 48075-7901
(248) 827-3370
(248) 827-7234
Mailing address
21298 MELROSE AVE, SOUTHFIELD, MI 48075-7901
(248) 827-3370
(248) 827-7234

Taxonomy

Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
332B00000X
Durable Medical Equipment & Medical Supplies
3336H0001X
Home Infusion Therapy Pharmacy
Primary
5301005157
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2579867
MI
05
2672638
MI
01
MI15863
MEDICARE HIT CERTIFICATION
Enumeration date
12/23/2005
Last updated
08/08/2025
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