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General NPI Number Information
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NPI Number | 1346275856
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Entity Type | Organization
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Legal Business Name | BRONSON SOUTH HAVEN HOSPITAL
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 12/27/2023
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Provider Practice Location Address
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Address Line | 955 S BAILEY AVE
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City | SOUTH HAVEN
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State | MI
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Zip | 49090-9701
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Country | US
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Telephone | 269-637-5271
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Fax | 269-639-2818
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Provider Business Mailing Address
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Address Line | 601 JOHN ST BOX 42
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City | KALAMAZOO
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State | MI
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Zip | 49007
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Country | US
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Telephone | 269-341-8419
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Fax | 269-341-8913
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Authorized Official
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Title or Position | SVP, CFO
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Name | MS. REBECCA L EAST
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Credential |
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Telephone | 269-341-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 800020
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License Number State | MI
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