Fairlane Pharmacy Services Corp.

LBN: Henry Ford Health System
Fairlane Pharmacy Services Corp. is an health care organization with primary practice located at 22505 Allen Rd , Woodhaven MI 48183-2237. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Henry Ford Health System can be contacted via phone (248) 723-0020, or through Kus, Daniel via phone (248) 642-1111.

Contact Information

Primary practice address
22505 Allen Rd Woodhaven MI 48183-2237
Phone: (248) 723-0020
Fax: (248) 642-6094
Website:
Map and Directions
Authorized official contact:
Name: Kus, Daniel RPH
Phone: (248) 642-1111

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 5301004669 Michigan

Profile Details

NPI number 1629162029
LBN Legal business name Henry Ford Health System
DBA Doing business as Fairlane Pharmacy Services Corp.
Authorized official Kus, Daniel RPH
Entity Organization
Organization subpart 1 No
Enumeration date Oct 3rd, 2006
Last updated Dec 1st, 2016 - about 10 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 1629162029 NPPES
Other 2040107 PK
MEDICAID 1830240 PK

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