# LAKELAND MEDICAL CENTER NILES

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053474734
- **Authorized official:** TIM J CALHOUN (VP FINANCE/CFO)
- **Authorized official phone:** (269) 983-8300

## Contact information

- **Practice address:** 31 N SAINT JOSEPH AVE, NILES, MI 49120-2207
- **Practice address phone:** (269) 687-1428
- **Mailing address:** 31 N SAINT JOSEPH AVE, NILES, MI 49120-2207
- **Mailing address phone:** (269) 687-1428

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | 5301000048 | MI | Yes |

## Other

- **Enumeration date:** 12/18/2006
- **Last updated:** 04/06/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2324135 | NCPDP | — |