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Contact Information

DETROIT COMMUNITY HEALTH CONNECTION
7900 KERCHEVAL ST
DETROIT, MI48214-2439
 Phone: 313-924-9798
 Fax: 313-924-6244
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinic Pharmacy

3336C0002X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for DETROIT COMMUNITY HEALTH CONNECTION

NPI Number 1679737480
LBN Legal business name DETROIT COMMUNITY HEALTH CONNECTION
Authorized official WAYNE BRADLEY - (PRESIDENT & CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 07/11/2008
Last updated 03/22/2019 - About 7 years ago
Identifiers
MI License # 5301008896
MI Medicaid 1679737480
Other 2116456 PK
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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