Healthcare Provider Details

I. General information

NPI: 1407072754
Provider Name (Legal Business Name): BRONSON SOUTH HAVEN HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 S BAILEY AVE STE 200
SOUTH HAVEN MI
49090-6743
US

IV. Provider business mailing address

601 JOHN ST BOX 42
KALAMAZOO MI
49007-5341
US

V. Phone/Fax

Practice location:
  • Phone: 269-637-5271
  • Fax: 269-639-2818
Mailing address:
  • Phone: 269-341-6000
  • Fax: 269-341-8913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number800020
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number1060000042
License Number StateMI

VIII. Authorized Official

Name: MS. REBECCA L EAST
Title or Position: SVP, CFO
Credential:
Phone: 269-341-6000