Healthcare Provider Details
I. General information
NPI: 1932523412
Provider Name (Legal Business Name): STURGIS HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/05/2014
Last Update Date: 02/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
916 MYRTLE ST
STURGIS MI
49091-2326
US
IV. Provider business mailing address
916 MYRTLE ST
STURGIS MI
49091-2326
US
V. Phone/Fax
- Phone: 269-651-7824
- Fax:
- Phone: 269-651-7824
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ROBERT
LABARGE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 269-651-7824