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Organization
NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION
Active
Organization
NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION
Active
Other names
Spectrum Health Gerber Memorial
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL J STASIK (PRESIDENT AND CEO)
(231) 924-1340
Entity
Organization
Contact information
Practice address
212 S SULLIVAN ST, FREMONT, MI 49412
(231) 924-1300
(231) 924-1320
Mailing address
212 S SULLIVAN ST, FREMONT, MI 49412
(231) 924-1300
(231) 924-1320
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
—
MI
367500000X
Certified Registered Nurse Anesthetist
620010
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00088
BCBSM
MI
05
—
301557097
—
MI
05
—
405170667
—
MI
01
—
423
PRIORITY HEALTH
MI
05
—
9451
—
MI
Enumeration date
06/22/2005
Last updated
07/21/2022
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