Organization
HENRY FORD MACOMB HOSPITAL CORPORATION
Active
Other names
HENRY FORD MACOMB AMBULATORY PHARMACY #1
Organization subpart
No
Provider details
NPI number
Authorized official
DAN KUS RPH (VP OF PHARMACY)
(248) 723-0255
Entity
Organization
Contact information
Practice address
16151 19 MILE RD, STE 100, CLINTON TWP, MI 48038-1158
(586) 263-2677
(586) 263-2567
Mailing address
16151 19 MILE RD, STE 100, CLINTON TWP, MI 48038-1158
(586) 263-2677
(586) 263-2567
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301005814
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2042145
PK
—
05
—
2350863
—
MI
Enumeration date
08/10/2006
Last updated
01/19/2017
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