Healthcare Provider Details

I. General information

NPI: 1093748642
Provider Name (Legal Business Name): SAINT JOSEPH MERCY LIVINGSTON HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 BYRON RD
HOWELL MI
48843-1002
US

IV. Provider business mailing address

620 BYRON RD
HOWELL MI
48843-1002
US

V. Phone/Fax

Practice location:
  • Phone: 517-545-6000
  • Fax:
Mailing address:
  • Phone: 517-545-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL PAUL GUSHO
Title or Position: REGIONAL CFO
Credential:
Phone: 231-672-3886