OrganizationWilliam Beaumont Hospital(Beaumont Professional Services)Internal MedicineAllopathic & Osteopathic PhysiciansPractice Address3601 W 13 Mile Rd, Royal Oak, MI 48073-6712(248) 423-2454(947) 522-1964PECOS EnrollmentBased on the most recent information from CMS, provider William Beaumont Hospital does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:21 AM.Profile DetailsProvider ID1295959245Provider TypeOrganizationFull NameWilliam Beaumont HospitalOther NameBeaumont Professional ServicesSubpartNoEnumeration Date4/12/2007Last Updated10/1/2021Contact InformationPractice LocationPractice Address3601 W 13 Mile Rd, Royal Oak, MI 48073-6712Phone(248) 423-2454Fax(248) 423-2576Mailing LocationMailing Address26901 Beaumont Blvd, Compliance, Southfield, MI 48033-3849Phone(947) 522-1964FaxUnlisted FaxAuthorized OfficialNameOdom, Lee Ann (President Shared Services)Phone(947) 522-3326Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerIDUC630009DescriptionOtherIssuerMCAREMichigan