Healthcare Provider Details

I. General information

NPI: 1568681997
Provider Name (Legal Business Name): HILLS & DALES GENERAL HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 03/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5854 STATE ST
KINGSTON MI
48741-9524
US

IV. Provider business mailing address

5854 STATE ST
KINGSTON MI
48741-9524
US

V. Phone/Fax

Practice location:
  • Phone: 989-683-8065
  • Fax: 989-683-8088
Mailing address:
  • Phone: 989-683-8065
  • Fax: 989-683-8088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KENNETH E BARANSKI
Title or Position: CHIEF FINANCIAL OFFICER
Credential: CFO
Phone: 989-912-6225