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NPI Code Detail

MEDICARE: DECKERVILLE COMMUNITY HOSPITAL, INC

MEDICARE: DECKERVILLE COMMUNITY HOSPITAL, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1013799469
Entity Type Code : Organization
Provider Name (Legal Business Name) : DECKERVILLE COMMUNITY HOSPITAL, INC
Provider Business Mailing Address
First Line : PO BOX 126
Second Line :
City : DECKERVILLE
State : MI
Zip : 48427-0126
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 245 S RIDGE ST
Second Line :
City : PORT SANILAC
State : MI
Zip : 48469-9704
Country : US
Telephone Number : 810-376-2835
Fax Number :
Authorized Official
Title or Position : CEO
Name : ANGELA MCCONNACHIE
Credential :
Telephone Number : 989-635-4000
Provider Enumeration Date : 10/19/2023
Last Update Date : 12/14/2023

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Directions to “DECKERVILLE COMMUNITY HOSPITAL, INC ” Practice Location

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