Healthcare Provider Details

I. General information

NPI: 1609803717
Provider Name (Legal Business Name): IONIA COUNTY MEMORIAL HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 07/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 LAFAYETTE ST
IONIA MI
48846-1836
US

IV. Provider business mailing address

PO BOX 13008
LANSING MI
48901-3008
US

V. Phone/Fax

Practice location:
  • Phone: 616-527-7060
  • Fax: 616-527-5731
Mailing address:
  • Phone: 616-523-1400
  • Fax: 616-527-5731

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: WILLIAM ROESER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 616-527-4200