Organization
BOTSFORD GENERAL HOSPITAL
Active
Parent organization
BOTSFORD GENERAL HOSPITAL
Other names
Botsford Outreach Lab
Organization subpart
Yes
Provider details
NPI number
Legal business name
BOTSFORD GENERAL HOSPITAL
Authorized official
LEE ANN ODOM (PRESIDENT SHARED SERVICES)
(947) 522-3326
Entity
Organization
Contact information
Practice address
28050 GRAND RIVER AVE, FARMINGTON HILLS, MI 48336-5919
(248) 471-8000
Mailing address
26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00276
BLUE CROSS
MI
01
—
230151
CARE CHOICES
MI
05
—
5170228
—
MI
Enumeration date
06/21/2006
Last updated
10/18/2021
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