Organization
VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JAYME S THOMPSON (PROGRAM SUPPORT ASSISTANT)
(734) 845-3007
Entity
Organization
Contact information
Practice address
2215 FULLER RD, ANN ARBOR, MI 48105-2303
(734) 761-7926
(734) 769-7410
Mailing address
17194 CAMERON DR, NORTHVILLE, MI 48168-3211
(248) 449-2644
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
4301060642
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10890224
CAQH
MI
Enumeration date
06/25/2006
Last updated
02/23/2009
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