Organization
HENRY FORD MACOMB HOSPITAL CORPORATION
Active
Other names
HENRY FORD MACOMB AMBULATORY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL KUS RPH (VP PHARMACY OPERATIONS)
(248) 723-0255
Entity
Organization
Contact information
Practice address
30795 23 MILE RD, CHESTERFIELD, MI 48047-5720
(586) 421-3020
(586) 421-3021
Mailing address
30795 23 MILE RD, CHESTERFIELD, MI 48047-5720
(586) 421-3020
(586) 421-3021
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301007383
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2045556
PK
—
05
—
2362705
—
MI
Enumeration date
09/21/2006
Last updated
12/05/2016
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