DETROIT MEDICAL CENTER (NPI# 1346391539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346391539 |
| Entity Type | Organization |
| Organization Name | DETROIT MEDICAL CENTER |
| Practice Address |
4201 Saint Antoine St 2c Uhc Detroit MI 48201-2153 |
| Practice Telephone | 3139930724 |
| Practice Fax Number | 3137459661 |
| Mailing Telephone | 3139930724 |
| Mailing Fax Number | 3137459661 |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2007-12-28 |
| Authorized Official Name | MS. VERDELL TOLBERT (VICE PRESIDENT OF LABORATORY SERVIC) |
| Authorized Official Telephone | 3139930724 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | MI | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 2888352 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982154365 | Detroit Medical Center | General Acute Care Hospital | 4713 Pond Run, Canton, MI 48188-2196 | 2016-10-10 |
| 1619332574 | Detroit Medical Center | Clinic/Center | 43205 Creekview Dr, Canton, MI 48187-3049 | 2015-12-19 |
| 1043551146 | Detroit Medical Center | General Acute Care Hospital | 3990 John R Rd, Detroit, MI 48201 | 2013-03-14 |
| 1174837686 | Detroit Medical Center | General Acute Care Hospital | 4201 St. Antoine- 6g Uhc, 6g Uhc, Detroit, MI 48201 | 2010-07-27 |
| 1326279803 | Detroit Medical Center | Special Hospital | 39180 Citation Pl, Apt # 35104, Farmington Hills, MI 48331-4901 | 2009-08-02 |
| 1356510085 | Detroit Medical Center | Clinic/Center | 4201 Saint Antoine St Ste 2e, Detroit, MI 48201-2153 | 2008-02-27 |
| 1699327429 | Detroit Medical Center | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2019-07-11 |
| 1205178761 | Detroit Medical Center | Psychiatry & Neurology | 3901 Beaubien St, Department of Neurology, Children's Hospital of Michiga, Detroit, MI 48201-2119 | 2013-03-22 |
| 1346508157 | Detroit Medical Center | Special Hospital | 4160 John R St, Detroit, MI 48201-2020 | 2012-04-30 |
| 1770853251 | Detroit Medical Center | Emergency Medicine | 6071 W Outer Dr, Emergency Medicine Department, Detroit, MI 48235-2624 | 2011-12-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DETROIT MEDICAL CENTER | 3990 John R St, Detroit, MI 48201-2018 |
| Street Address |
4201 SAINT ANTOINE ST 2C UHC |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760477871 | John Mckay Perkowski | Nurse Anesthetist, Certified Registered | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2005-09-14 |
| 1013517028 | Madappulli Arachchige Wickrama | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-10-28 |
| 1134731466 | Helda Bacall | Nurse Practitioner | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-08-18 |
| 1568088680 | Michelle De Varennes | Physician Assistant | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-24 |
| 1235754144 | Saren Yeranosian | Pharmacist | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-16 |
| 1083239230 | Jacqueline Ferraro-jaworski | Pharmacist | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-13 |
| 1770107617 | Zamaan Sayeed Sohel | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-06 |
| 1881218790 | Erin Marie Dinnell | Nurse Practitioner | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-06-05 |
| 1487276721 | Andrew R Kumar | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-05-09 |
| 1598386005 | Kayla Richelle Robinson | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2020-05-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972137560 | Functional Fluidics LLC | Clinical Medical Laboratory | 440 Burroughs St Ste 641, Detroit, MI 48202-3474 | 2020-02-24 |
| 1538542964 | Angela Johnson | Clinical Medical Laboratory | 17300 Santa Barbara Dr, Detroit, MI 48221-2527 | 2015-07-02 |
| 1326283276 | Genesis Genetics Institute, LLC | Clinical Medical Laboratory | 1380 E Jefferson Ave, Detroit, MI 48207-3104 | 2008-12-06 |
| 1861018749 | Functional Fluidics Inc | Clinical Medical Laboratory | 440 Burroughs St Ste 641, Detroit, MI 48202-3474 | 2020-06-17 |
| 1689293458 | World Wide Clinical Labz LLC | Clinical Medical Laboratory | 5575 Conner St, Detroit, MI 48213-6400 | 2020-04-13 |
| 1861934168 | Natlab Inc | Clinical Medical Laboratory | 3011 W Grand Blvd, Suite 309, Detroit, MI 48202-3096 | 2016-11-17 |
| 1144645235 | National Laboratories Inc | Clinical Medical Laboratory | 3011 W Grand Blvd, Suite 310, Detroit, MI 48202-3096 | 2014-02-26 |
| 1992135792 | Henry Ford Health System | Clinical Medical Laboratory | 440 Burroughs St, Techtown, Detroit, MI 48202-3429 | 2013-11-15 |
| 1366744823 | Vhs University Laboratories Inc | Clinical Medical Laboratory | 4707 Saint Antoine St, Detroit, MI 48201-1427 | 2010-12-03 |
| 1124338488 | City of Detroit | Clinical Medical Laboratory | 3245 E Jefferson Ave Ste 100, Detroit, MI 48207-4222 | 2010-10-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.