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General NPI Number Information
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NPI Number | 1376354563
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Entity Type | Organization
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Legal Business Name | DECKERVILLE COMMUNITY HOSPITAL, INC.
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 2030 BLACK RIVER ST
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City | DECKERVILLE
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State | MI
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Zip | 48427-9440
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Country | US
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Telephone | 810-376-2835
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 126
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City | DECKERVILLE
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State | MI
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Zip | 48427-0126
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ANGELA MCCONNACHIE
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Credential |
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Telephone | 989-635-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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