Healthcare Provider Details

I. General information

NPI: 1477981124
Provider Name (Legal Business Name): PORTAGE HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2013
Last Update Date: 01/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 W WATER ST
HANCOCK MI
49930-1953
US

IV. Provider business mailing address

330 SEVEN SPRINGS WAY
BRENTWOOD TN
37027-4536
US

V. Phone/Fax

Practice location:
  • Phone: 906-483-1160
  • Fax: 906-483-1167
Mailing address:
  • Phone: 615-920-7000
  • Fax: 615-920-8913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY G. SERAPHINE
Title or Position: PRESIDENT
Credential:
Phone: 615-372-8500