Healthcare Provider Details

I. General information

NPI: 1295974863
Provider Name (Legal Business Name): ASPIRUS ONTONAGON HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2009
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13833 US HIGHWAY 45
BRUCE CROSSING MI
49912-9355
US

IV. Provider business mailing address

29980 NETWORK PL
CHICAGO IL
60673-1299
US

V. Phone/Fax

Practice location:
  • Phone: 906-827-3201
  • Fax: 906-827-3203
Mailing address:
  • Phone: 715-847-2304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LORI PECK
Title or Position: VP OF REVENUE CYCLE
Credential:
Phone: 715-847-2000