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Organization

W. A. FOOTE MEMORIAL HOSPITAL, INC

Active
Parent organization
W A FOOTE MEMORIAL HOSPITAL, INC.
Other names
Henry Ford Jackson Home Medical, Henry Ford Allegiance Home Medical
Organization subpart
Yes

Provider details

NPI number
Legal business name
W A FOOTE MEMORIAL HOSPITAL, INC.
Authorized official
MARK SMITH M.D. (SVP CEO)
(313) 874-4806
Entity
Organization

Contact information

Practice address
700 E MICHIGAN AVE, JACKSON, MI 49201-1626
(517) 768-8873
(517) 780-3816
Mailing address
700 E MICHIGAN AVE, JACKSON, MI 49201-1626
(517) 768-8873
(517) 780-3816

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
380010
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
468131387
MI
01
540C800660
BLUE CROSS OF MICHIGAN
MI
01
540C811250
BLUE CROSS OF MICHIGAN
MI
01
82-20024
PHYSICIAN'S HEALTH PLAN
MI
Enumeration date
10/06/2006
Last updated
03/31/2026
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