HENRY FORD MACOMB ANCILLARY SERVICES (NPI# 1669864708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669864708 |
| Entity Type | Organization |
| Organization Name | HENRY FORD MACOMB ANCILLARY SERVICES |
| Other Organization Name | HENRY FORD MACOMB LAB SERVICES-MT. CLEMENS |
| Practice Address |
133 S Main St Mount Clemens MI 48043-2308 |
| Mailing Address |
15855 19 Mile Rd Attn: Terry Goodbalian Clinton Township MI 48038-3504 |
| Practice Telephone | 5864681600 |
| Practice Fax Number | 5864650329 |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2015-03-04 |
| Authorized Official Name | TERRY GOODBALIAN (VP FINANCE & CFO HFMACOMB) |
| Authorized Official Telephone | 5862632705 |
| Is Organization Subpart | Y |
| Parent Organization Name | HENRY FORD MACOMB HOSPITAL CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Other Name | Type Code |
|---|---|
| HENRY FORD MACOMB LAB SERVICES-MT. CLEMENS | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689062911 | Henry Ford Macomb Ancillary Services | Physiological Laboratory | 133 S Main St, Mount Clemens, MI 48043-2308 | 2015-01-09 |
| Street Address |
133 S MAIN ST |
| City | MOUNT CLEMENS |
| State | MI |
| Zip Code | 48043-2308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306842190 | Internal Medicine Associates of Mt. Clemens, PC | Internal Medicine | 133 S Main St, Mount Clemens, MI 48043-2308 | 2005-06-26 |
| 1669973194 | Kathryn Loren | Social Worker | 133 S Main St, Mount Clemens, MI 48043-2308 | 2018-02-21 |
| 1225406259 | Joseph Scherba | Physician Assistant | 133 S Main St, Mount Clemens, MI 48043-2308 | 2015-09-08 |
| 1396111860 | Nicole Cherie Williams | Nurse Practitioner | 133 S Main St, Mount Clemens, MI 48043-2308 | 2015-08-19 |
| 1073999629 | Nicole Marie Shields | Physician Assistant | 133 S Main St, Mount Clemens, MI 48043-2308 | 2015-08-05 |
| 1689062911 | Henry Ford Macomb Ancillary Services | Physiological Laboratory | 133 S Main St, Mount Clemens, MI 48043-2308 | 2015-01-09 |
| 1578973962 | Lubna Sarraf | Internal Medicine | 133 S Main St, Mount Clemens, MI 48043-2308 | 2014-05-06 |
| 1841615648 | Alliance Health Professionals, Pllc | Internal Medicine | 133 S Main St, Mount Clemens, MI 48043-2308 | 2014-03-03 |
| 1962763078 | Jahir Eduardo Ramos | Internal Medicine | 133 S Main St, Mount Clemens, MI 48043-2308 | 2012-06-05 |
| 1497074264 | Nikhil Vivek Ambulgekar | Internal Medicine | 133 S Main St, Mount Clemens, MI 48043 | 2010-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699300228 | Blue Diamond Aba Services LLC | Assistant Behavior Analyst | 102 North Avenue, Mt. Clemens, MI 48043 | 2020-03-04 |
| 1265086136 | Venture Counseling | Social Worker | 198 S. Main Street, Suite 2, Mount Clemens, MI 48043 | 2019-07-30 |
| 1386203651 | Michele Lee Casebolt | Physical Therapist | 30795 Twenty Three Mile Rd., Chesterfield, MI 48043 | 2019-06-11 |
| 1730669706 | Wynn A Mitchell | Case Manager/Care Coordinator | 24 Hubbard St, Mount Clemens, MI 48043 | 2018-08-18 |
| 1629520101 | Boitshoko Marang | Family Medicine | Clinton River Drive 11a, Mount Clemens, MI 48043 | 2016-10-31 |
| 1720332265 | New Passages | Point of Service | 175 N. Grorsebeck Hwy, Mt. Clemens, MI 48043 | 2012-11-06 |
| 1376807784 | Christopher John Shamass | Emergency Medicine | 1000 Harrington Boulevard, Mount Clemens, MI 48043 | 2012-06-29 |
| 1265749683 | Mycare Health Center | Clinic/Center | 18 Market Street, Suite C, Mount Clemens, MI 48043 | 2010-09-07 |
| 1114102837 | George Edward Perron | Family Medicine | 256 Wellington Crescent, Mt Clemens, MI 48043 | 2007-12-31 |
| 1558568733 | Dawood Ghassan Dalaly | Surgery | 1000 Harrington, Mt Clemens, MI 48043 | 2007-06-29 |
| Find all providers in zip 48043 | ||||
| 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 |
|---|---|---|---|---|
| 1033726633 | Shores Diagnostic LLC | Clinical Medical Laboratory | 3611 Carpenter St Ste 6, Hamtramck, MI 48212-2784 | 2020-09-28 |
| 1952918831 | United Medical Laboratory LLC | Clinical Medical Laboratory | 30675 Stephenson Hwy, Suite B, Madison Heights, MI 48071 | 2020-09-25 |
| 1407466253 | Van Laan Industries Inc. | Clinical Medical Laboratory | 3414 Lovers Ln Ste A, Kalamazoo, MI 49001-4806 | 2020-08-06 |
| 1164049524 | Rapid Biosense LLC | Clinical Medical Laboratory | 46701 Commerce Center Dr, Plymouth, MI 48170-2475 | 2020-07-01 |
| 1023631595 | Catalyst Diagnostic LLC | Clinical Medical Laboratory | 4942 Dawn Ave Ste 210, East Lansing, MI 48823-5606 | 2020-05-19 |
| 1467073460 | Lynx Dx Inc | Clinical Medical Laboratory | 333 Jackson Plz Ste 600, Ann Arbor, MI 48103-1922 | 2020-04-30 |
| 1184245219 | Olive Labs, Inc. | Clinical Medical Laboratory | 150 Livernois St, Ferndale, MI 48220-2302 | 2020-04-29 |
| 1720617947 | Covenant Pathology Associates, PC | Clinical Medical Laboratory | 4707 Mcleod Dr E, Saginaw, MI 48604-2853 | 2020-04-08 |
| 1134757339 | Vibra of Southeastern Michigan, LLC | Clinical Medical Laboratory | 1307-a Allen Drive, Troy, MI 48083-4010 | 2020-04-01 |
| 1972137560 | Functional Fluidics LLC | Clinical Medical Laboratory | 440 Burroughs St Ste 641, Detroit, MI 48202-3474 | 2020-02-24 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT CLEMENS |
| Zip Code | 48043 |
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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.