Organization
ST JOHN MACOMB OAKLAND HOSPITAL
Active
Other names
St John Macomb Oakland Hospital - St John Detroit Riverview Center
Organization subpart
No
Provider details
NPI number
Authorized official
RANDOLPH KUMMLER (VP FINANCE)
(586) 573-5910
Entity
Organization
Contact information
Practice address
7733 E JEFFERSON AVE, DETROIT, MI 48214-3707
(313) 499-4000
Mailing address
28000 DEQUINDRE RD, WARREN, MI 48092-2468
(586) 753-0275
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
282N00000X
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00048
BLUE CROSS PIN
—
Enumeration date
05/13/2008
Last updated
06/17/2008
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