Providence-Providence Park Hospital

LBN: Ascension Providence Hospital
Providence-Providence Park Hospital is an health care organization with primary practice located at 16001 W 9 Mile Rd , Southfield MI 48075-4818. The organization recently has only one registered license in Hospital Units / Rehabilitation Unit, which is considered as the primary health care specialty. Ascension Providence Hospital can be contacted via phone (248) 849-3000, or through Russell, Brant M via phone (248) 849-3400.

Contact Information

Primary practice address
16001 W 9 Mile Rd Southfield MI 48075-4818
Phone: (248) 849-3000
Fax: (248) 746-0384
Website:
Map and Directions
Authorized official contact:
Name: Russell, Brant M
Phone: (248) 849-3400

Health care specialties

SpecialtyCodeLicense #State
Hospital Units / Rehabilitation Unit 273Y00000X

Profile Details

NPI number 1255316584
LBN Legal business name Ascension Providence Hospital
DBA Doing business as Providence-Providence Park Hospital
Authorized official Russell, Brant M
Entity Organization
Organization subpart 1 No
Enumeration date Dec 9th, 2005
Last updated Aug 10th, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255316584 NPPES
Michigan MEDICAID 2775475

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