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General NPI Number Information
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NPI Number | 1821081639
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Entity Type | Organization
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Legal Business Name | BRONSON METHODIST HOSPITAL
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Dates
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Enumeration Date | 08/26/2005
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Last Update Date | 03/10/2021
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Provider Practice Location Address
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Address Line | 451 HEALTH PKWY
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City | PAW PAW
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State | MI
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Zip | 49079-8242
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Country | US
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Telephone | 269-668-6205
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Fax | 269-668-5071
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Provider Business Mailing Address
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Address Line | 52375 N MAIN ST
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City | MATTAWAN
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State | MI
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Zip | 49071-9332
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Country | US
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Telephone | 269-668-6205
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Fax | 269-668-5071
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Authorized Official
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Title or Position | CFO
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Name | MRS. REBECCA EAST
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Credential |
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Telephone | 269-341-8536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 5301006938
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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