Organization
DECKERVILLE COMMUNITY HOSPITAL, INC.
Active
Parent organization
DECKERVILLE COMMUNITY HOSPITAL, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
DECKERVILLE COMMUNITY HOSPITAL, INC.
Authorized official
KIMBERLY GENTNER (CFO)
(810) 376-2835
Entity
Organization
Contact information
Practice address
3559 PINE STREET, DECKERVILLE, MI 48427
(810) 376-2835
(810) 376-9412
Mailing address
3559 PINE STREET, DECKERVILLE, MI 48427
(810) 376-2835
(810) 376-9412
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138358
GREAT LAKES HEALTH PLAN
MI
01
—
G61003
BCBSM
MI
Enumeration date
03/26/2007
Last updated
10/05/2017
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