Healthcare Provider Details

I. General information

NPI: 1154504892
Provider Name (Legal Business Name): ASCENSION BORGESS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2007
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 NAOMI ST
PLAINWELL MI
49080-1222
US

IV. Provider business mailing address

411 NAOMI ST
PLAINWELL MI
49080-1222
US

V. Phone/Fax

Practice location:
  • Phone: 269-685-0700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number03-0031
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number State

VIII. Authorized Official

Name: MARINA HOUGHTON
Title or Position: CFO
Credential:
Phone: 269-226-4800