Organization Name: | ST JOHN MEDICAL CENTER MACOMB TOWNSHIP |
NPI Number: | 1083746820 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TOMASINE MARX (CFO) |
Mailing Address: | 17700 23 Mile Rd Macomb |
State: | MI US |
Postal Code: | 480441154 |
Phone Number: | 5867530011 |
Fax Number: | |
NPI Enumeration Date: | 03/09/2007 |
NPI Last Update Date: | 12/03/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QU0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Urgent Care |
Taxonomy Definition: |