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General NPI Number Information
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NPI Number | 1518681550
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Entity Type | Organization
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Legal Business Name | HOSPICE CARE OF SOUTHWEST MICHIGAN
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Dates
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Enumeration Date | 10/03/2022
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 2255 W CENTRE AVE
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City | PORTAGE
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State | MI
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Zip | 49024-4819
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Country | US
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Telephone | 269-345-0273
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Fax | 269-345-8522
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Provider Business Mailing Address
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Address Line | 7100 STADIUM DR
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City | KALAMAZOO
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State | MI
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Zip | 49009-9423
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Country | US
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Telephone | 269-345-0273
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Fax | 269-345-8522
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | LEE ANN MYERS
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Credential |
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Telephone | 313-578-6244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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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 | 2080H0002X
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Taxonomy Name | Pediatric Hospice and Palliative Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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