NPIMap

Organization Active NPI

W. a. Foote Memorial Hospital, Inc

Doing business as Henry Ford Allegiance Health

  • Clinical Medical Laboratory
  • Grass Lake, MI
National Provider Identifier
1861996753
Registry record updated Mar 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
W. A. FOOTE MEMORIAL HOSPITAL, INC
Doing business as
Henry Ford Allegiance Health
Practice address
12369 E Michigan Ave
Grass Lake, MI 49240-9213
Phone
(517) 205-2539
Fax
(517) 205-0105
NPI assigned
Mar 23, 2018
Last updated
Mar 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2018

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

Authorized official

Name
Kevin Leonard
Title
VP Finance
Phone
(517) 205-7843

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

12369 E Michigan Ave
Grass Lake, MI 49240-9213

Mailing address

PO Box 67000 Dept 272801
Detroit, MI 48267-0001
Phone (517) 205-7843

Other names 1

  • Henry Ford Allegiance Health 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
23D1020436Henry Ford Jackson-Grass Lake12369 E Michigan Avenue, Grass Lake, MI 49240Certificate of waiverDec 18, 2027

National Provider Directory

National Provider Directory
Tax ID family
Foote HLTH Ctr Pha104 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521763200000",
    "number": "1861996753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67000 DEPT 272801",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482670001",
            "telephone_number": "517-205-7843",
            "fax_number": "517-205-7419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12369 E MICHIGAN AVE",
            "city": "GRASS LAKE",
            "state": "MI",
            "postal_code": "492409213",
            "telephone_number": "517-205-2539",
            "fax_number": "517-205-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W. A. FOOTE MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-23",
        "last_updated": "2018-03-23",
        "status": "A",
        "authorized_official_last_name": "LEONARD",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "517-205-7843"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henry Ford Allegiance Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grass Lake, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; 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.