DETROIT MEDICAL CENTER; NPI #1619332574

Contact Information

DETROIT MEDICAL CENTER

43205 CREEKVIEW DR
CANTON, MI 48187-3049

Phone: 734-844-7241
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Children	282NC2000X	A0[7]	Hospital-Childrenâ€™s (PPS excluded)
End-Stage Renal Disease (ESRD) Treatment	261QE0700X	B4[14]	End-Stage Renal Disease Facility
General Acute Care Hospital	282N00000X	A0[7]	Hospital-General

Indicates primary specialty

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NPI Profile & details for DETROIT MEDICAL CENTER

NPI # 1619332574

LBN Legal business name DETROIT MEDICAL CENTER

Authorized official TRACEY TYUS-BAILEY - (CLINICAL SOCIAL WORKER)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 12/19/2015

Last updated 12/19/2015 - About 10 years ago

Identifiers

MI	License #	6801067466
MI	Other	6801067466	MICHIGAN LICENSE NUMBER

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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