Provider Demographics
NPI:1548451164
Name:HENRY FORD HEALTH-MAIN HOSPITAL
Entity type:Organization
Organization Name:HENRY FORD HEALTH-MAIN HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ST. JOHN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:313-916-1154
Mailing Address - Street 1:918 W 13 MILE RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-2412
Mailing Address - Country:US
Mailing Address - Phone:248-342-8946
Mailing Address - Fax:
Practice Address - Street 1:2799 W GRAND BLVD STE E1635
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-1154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801086542281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital