MEDICARE: CALHOUN COUNTY MEDICAL CARE FACILITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center
2	314000000X	Skilled Nursing Facility	138520	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	09739	OTHER	MI	BLUE CROSS PROVIDER NUMBE

General Provider Information

NPI Number	:	1548232127
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALHOUN COUNTY MEDICAL CARE FACILITY

Provider Business Mailing Address
First Line	:	1150 MICHIGAN AVE E
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49014-6113
Country	:	US
Telephone Number	:	269-962-5458
Fax Number	:	269-962-7011

Provider Business Practice Location Address
First Line	:	1150 MICHIGAN AVE E
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49014-6113
Country	:	US
Telephone Number	:	269-962-5458
Fax Number	:	269-962-7011

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	STEPHANIE CORNISH
Credential	:
Telephone Number	:	269-962-5458

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	10/27/2025

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