Healthcare Provider Details

I. General information

NPI: 1841252251
Provider Name (Legal Business Name): HERRICK MEMORIAL HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 12/22/2023
Certification Date: 12/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E POTTAWATAMIE ST
TECUMSEH MI
49286-2018
US

IV. Provider business mailing address

500 E POTTAWATAMIE ST
TECUMSEH MI
49286-2018
US

V. Phone/Fax

Practice location:
  • Phone: 517-424-3000
  • Fax: 517-265-0496
Mailing address:
  • Phone: 517-424-3000
  • Fax: 517-265-0496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: KEVIN SHARP
Title or Position: VP REV CYCLE
Credential:
Phone: 567-585-7576