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NPI Code Detail

MEDICARE: SHERIDAN COMMUNITY HOSPITAL

MEDICARE: SHERIDAN COMMUNITY HOSPITAL
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
1282NC0060XCritical Access Hospital

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
200057OTHERMIBCBSM PROVIDER #
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689618324
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHERIDAN COMMUNITY HOSPITAL
Provider Business Mailing Address
First Line : 301 N MAIN ST
Second Line : PO BOX 279
City : SHERIDAN
State : MI
Zip : 48884-9235
Country : US
Telephone Number : 989-291-3261
Fax Number : 989-291-3062
Provider Business Practice Location Address
First Line : 301 N MAIN ST
Second Line :
City : SHERIDAN
State : MI
Zip : 48884-9235
Country : US
Telephone Number : 989-291-3261
Fax Number : 989-291-3062
Authorized Official
Title or Position : CEO
Name : LJILJANA PETRICEVIC
Credential :
Telephone Number : 989-291-6222
Provider Enumeration Date : 06/15/2006
Last Update Date : 04/22/2021

Similar Medicare Providers

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Practice Location Address:
301 N MAIN ST
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48884-9235
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1811198849 — ELWOOD FRANK WILKINS JR. CRNA
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1275700262 — MICHIGAN MEDICAL PATIENT CARE
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48884-9235
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1053577908 — DR. MICHAEL BRAD CEARLOCK M.D.
Practice Location Address:
301 N MAIN ST
SHERIDAN, MI
48884-9235
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Practice Fax:
1013219351 — SPECTRUM HEALTH PRIMARY CARE PARTNERS
Practice Location Address:
301 N MAIN ST
SHERIDAN, MI
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Practice Fax:
1649689357 — SPECTRUM HEALTH UNITED
Practice Location Address:
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Practice Phone: 616-754-2944
Practice Fax: 616-754-2999

Directions to “SHERIDAN COMMUNITY HOSPITAL ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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