Organization
HENRY FORD HEALTH SYSTEM
Active
Other names
Henry Ford - CSI Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DAN KUS RPH (AMBULATORY PHARMACY DISTRECT M)
(248) 723-0255
Entity
Organization
Contact information
Practice address
1414 E MAPLE RD STE 103, TROY, MI 48083-9935
(248) 648-7221
(313) 567-0744
Mailing address
30100 TELEGRAPH RD, SUITE 200, DETROIT, MI 48207
(248) 723-0291
(248) 642-6094
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138933
PK
—
Enumeration date
02/12/2013
Last updated
11/28/2023
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