| St. John Hospital And Medical Center | |
|
22101 Moross Rd Detroit MI 48236-2148 | |
| (586) 753-0011 | |
| Not Available |
| Full Name | St. John Hospital And Medical Center |
|---|---|
| Speciality | Clinic/center |
| Location | 22101 Moross Rd, Detroit, Michigan |
| Authorized Official Name and Position | Christopher J Palazzolo (V.P. - FINANCE) |
| Authorized Official Contact | 3133433558 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. John Hospital And Medical Center 28000 Dequindre Rd Warren MI 48092-2468 Ph: (586) 753-0011 | St. John Hospital And Medical Center 22101 Moross Rd Detroit MI 48236-2148 Ph: (586) 753-0011 |
| NPI Number | 1740311604 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 02/24/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740311604 | NPI | - | NPPES |
| 0Q24580 | Other | MI | BCBSM PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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