Organization
ST JOSEPH MERCY HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL P GUSHO (SEMI REGIONAL CFO)
(734) 712-4041
Entity
Organization
Contact information
Practice address
5325 ELLIOTT DR, SUTIE 105, YPSILANTI, MI 48197-8633
(734) 712-8000
Mailing address
34505 W 12 MILE RD STE 200, FARMINGTON HILLS, MI 48331-3286
(734) 343-3922
Taxonomy
Speciality
Code
Description
License number
State
261QR0404X
Cardiac Rehabilitation Clinic/Center
Primary
1060000071
MI
Other
Enumeration date
07/26/2016
Last updated
10/05/2017
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