Healthcare Provider Details

I. General information

NPI: 1164679221
Provider Name (Legal Business Name): MARLETTE REGIONAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2008
Last Update Date: 08/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 MAIN ST
MARLETTE MI
48453-1141
US

IV. Provider business mailing address

2770 MAIN ST
MARLETTE MI
48453-1141
US

V. Phone/Fax

Practice location:
  • Phone: 989-635-4000
  • Fax: 989-635-5358
Mailing address:
  • Phone: 989-635-4000
  • Fax: 989-635-5358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIEL G. BABCOCK
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 989-635-4237