Organization Active NPI

Henry Ford Health System

Doing business as Henry Ford Medical Center Pharmacy

  • Community/Retail Pharmacy
  • Plymouth, MI
National Provider Identifier
1740374099
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301006864 Issued in MI
Legal business name
HENRY FORD HEALTH SYSTEM
Doing business as
Henry Ford Medical Center Pharmacy
Practice address
14300 N Beck Rd
Plymouth, MI 48170-3377
Phone
(734) 354-5950
Fax
(734) 354-5919
NPI assigned
Oct 3, 2006
Last updated
Dec 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Daniel Kus, RPH
Title
VP, Pharmacy Services
Phone
(248) 642-1111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 5301006864 MI Primary

Addresses

Primary practice location

14300 N Beck Rd
Plymouth, MI 48170-3377

Mailing address

30100 Telegraph Rd
Ste 200
Bingham Farms, MI 48025-4514
Phone (734) 354-5950

Other identifiers 2

IdentifierTypeStateIssuer
3509197MedicaidMI
2044287OtherPK

Other names 1

  • HENRY FORD MEDICAL CENTER PHARMACY Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0368433Henry Ford Medical Center Beck Road14300 Beck Road, Plymouth, MI 48170Certificate of waiverSep 19, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1740374099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30100 TELEGRAPH RD",
            "address_2": "STE 200",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254514",
            "telephone_number": "734-354-5950",
            "fax_number": "734-354-5919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 N BECK RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481703377",
            "telephone_number": "734-354-5950",
            "fax_number": "734-354-5919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY FORD HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "KUS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "VP, PHARMACY SERVICES",
        "authorized_official_telephone_number": "248-642-1111",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301006864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3509197",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2044287",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HENRY FORD MEDICAL CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.