Healthcare Provider Details

I. General information

NPI: 1255668893
Provider Name (Legal Business Name): STURGIS HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2009
Last Update Date: 06/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 E CHICAGO RD
STURGIS MI
49091-1993
US

IV. Provider business mailing address

916 MYRTLE ST
STURGIS MI
49091-2326
US

V. Phone/Fax

Practice location:
  • Phone: 269-651-7114
  • Fax:
Mailing address:
  • Phone: 269-659-6747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JO HAGOOD
Title or Position: ADMINISTRATIVE DIRECTOR SMG
Credential:
Phone: 269-659-6747