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General NPI Number Information
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NPI Number | 1497068639
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Entity Type | Organization
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Legal Business Name | W.A. FOOTE MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 07/16/2010
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Last Update Date | 07/16/2010
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Provider Practice Location Address
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Address Line | 205 N EAST AVE 7TH FLOOR ONE JACKSON SQUARE
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City | JACKSON
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State | MI
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Zip | 49201-1753
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Country | US
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Telephone | 517-788-4800
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Fax |
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Provider Business Mailing Address
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Address Line | 205 N EAST AVE 7TH FLOOR ONE JACKSON SQUARE
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City | JACKSON
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State | MI
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Zip | 49201-1753
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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 | MANAGER NUTRITION SERVICES
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Name | DEBRA WEAVER
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Credential | RD, MBA
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Telephone | 517-788-5210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State | MI
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