Healthcare Provider Details

I. General information

NPI: 1003132713
Provider Name (Legal Business Name): HILLS & DALES GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2010
Last Update Date: 07/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6190 HOSPITAL DR SUITE 105
CASS CITY MI
48726-1072
US

IV. Provider business mailing address

6190 HOSPITAL DR SUITE 105
CASS CITY MI
48726-1072
US

V. Phone/Fax

Practice location:
  • Phone: 989-912-6115
  • Fax: 989-912-6116
Mailing address:
  • Phone: 989-912-6115
  • Fax: 989-912-6116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberDP048720
License Number StateMI

VIII. Authorized Official

Name: KEN BARANSKI
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 989-912-6225