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General NPI Number Information
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NPI Number | 1598305641
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Entity Type | Organization
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Legal Business Name | LAKELAND HOSPITALS AT NILES AND ST JOSEPH, INC
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 04/23/2020
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Provider Practice Location Address
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Address Line | 1234 NAPIER AVE
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-2112
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Country | US
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Telephone | 616-486-6630
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Fax |
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Provider Business Mailing Address
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Address Line | 1234 NAPIER AVE
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-2112
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Country | US
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Telephone | 616-486-6630
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Fax |
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Authorized Official
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Title or Position | VP FINANCE
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Name | TIM J CALHOUN
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Credential |
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Telephone | 269-983-8304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology 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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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