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General NPI Number Information
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NPI Number | 1689650160
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Entity Type | Organization
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Legal Business Name | MEMORIAL MEDICAL CENTER OF WEST MICHIGAN
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Dates
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Enumeration Date | 12/16/2005
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Last Update Date | 07/15/2014
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Provider Practice Location Address
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Address Line | 1N ATKINSON DR
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City | LUDINGTON
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State | MI
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Zip | 49431-1906
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Country | US
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Telephone | 231-845-2270
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Fax | 231-845-2259
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Provider Business Mailing Address
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Address Line | 1 N ATKINSON DR
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City | LUDINGTON
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State | MI
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Zip | 49431-1906
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Country | US
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Telephone | 231-845-2270
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Fax | 231-845-2259
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Authorized Official
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Title or Position | VP FINANCE
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Name | KERRI NELSON
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Credential |
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Telephone | 231-845-2251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 538611
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License Number State | MI
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