Healthcare Provider Details

I. General information

NPI: 1528090594
Provider Name (Legal Business Name): SHERIDAN COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N MAIN ST
SHERIDAN MI
48884-0279
US

IV. Provider business mailing address

301 N MAIN ST PO BOX 279
SHERIDAN MI
48884-0279
US

V. Phone/Fax

Practice location:
  • Phone: 989-291-3261
  • Fax: 989-291-3062
Mailing address:
  • Phone: 989-291-3261
  • Fax: 989-291-3062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: LJILJANA PETRICEVIC
Title or Position: CEO
Credential:
Phone: 989-291-6222