Healthcare Provider Details

I. General information

NPI: 1548205586
Provider Name (Legal Business Name): COMMUNITY HEALTH CENTER OF BRANCH COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E CHICAGO ST
COLDWATER MI
49036-1688
US

IV. Provider business mailing address

274 E CHICAGO ST
COLDWATER MI
49036-2041
US

V. Phone/Fax

Practice location:
  • Phone: 517-279-5420
  • Fax: 517-279-5429
Mailing address:
  • Phone: 517-279-5400
  • Fax: 517-279-5429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number120010
License Number StateMI

VIII. Authorized Official

Name: RANDALL (RANDY) DEGROOT
Title or Position: CEO
Credential:
Phone: 517-279-5489