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General NPI Number Information
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NPI Number | 1760552574
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Entity Type | Organization
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Legal Business Name | HERRICK MEMORIAL HOSPITAL, INC.
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 02/25/2013
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Provider Practice Location Address
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Address Line | 502 EAST POTTAWATTAMIE ST.
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City | TECUMSEH
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State | MI
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Zip | 49286-2018
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Country | US
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Telephone | 517-424-3365
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Fax | 517-424-3902
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Provider Business Mailing Address
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Address Line | 502 EAST POTTAWATTAMIE ST.
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City | TECUMSEH
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State | MI
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Zip | 49286-2018
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Country | US
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Telephone | 517-424-3365
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Fax | 517-424-3902
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Authorized Official
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Title or Position | DIRECTOR
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Name | HAYLEY M. STUBER
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Credential |
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Telephone | 419-824-7576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 464010
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License Number State | MI
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