Organization
ASCENSION BORGESS HOSPITAL
Active
Organization
ASCENSION BORGESS HOSPITAL
Active
Other names
Ascension Rx 1311, Beacon Portage Outpatient Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY PETER COSTELLO (CFO)
(574) 647-3460
Entity
Organization
Contact information
Practice address
7901 ANGLING RD, PORTAGE, MI 49024-0714
(269) 324-8409
(269) 324-8458
Mailing address
7901 ANGLING RD, PORTAGE, MI 49024-0714
(269) 324-8409
(269) 324-8458
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301006331
MI
Other
Enumeration date
01/22/2007
Last updated
11/26/2025
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