Basic Information
| Provider Information | |||||||||
| NPI: | 1154624534 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VHS CHILDRENS HOSPITAL OF MICHIGAN INC | ||||||||
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| OtherOrganizationName: | DMC PHARMACY STILSON | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 BURTON HILLS BLVD STE 100 | ||||||||
| Address2: | ATTENTION: CAROL BAILEY | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372156409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6156656000 | ||||||||
| FaxNumber: | 6156656184 | ||||||||
| Practice Location | |||||||||
| Address1: | 42700 GARFIELD RD | ||||||||
| Address2: | SUITE 130 | ||||||||
| City: | CLINTON TOWNSHIP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480384201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5865322980 | ||||||||
| FaxNumber: | 5864161432 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/07/2010 | ||||||||
| LastUpdateDate: | 03/22/2022 | ||||||||
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| AuthorizedOfficialLastName: | JOSEPH | ||||||||
| AuthorizedOfficialFirstName: | LINSDAY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 3137455437 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336C0003X | 5301009481 | MI | Y | Suppliers | Pharmacy | Community/Retail Pharmacy |
No ID Information.