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General NPI Number Information
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NPI Number | 1598147803
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Entity Type | Organization
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Legal Business Name | ST JOSEPH MERCY OAKLAND
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Dates
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Enumeration Date | 06/23/2015
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Last Update Date | 06/23/2015
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Provider Practice Location Address
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Address Line | 874 GOLF DR APT 101
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City | PONTIAC
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State | MI
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Zip | 48341-2394
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Country | US
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Telephone | 408-478-5859
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Fax |
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Provider Business Mailing Address
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Address Line | 874 GOLF DR APT 101
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City | PONTIAC
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State | MI
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Zip | 48341-2394
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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 | SUPERVISOR
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Name | COURTNEY DOLAN
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Credential |
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Telephone | 248-858-3234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 4301107314
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License Number State | MI
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