Organization
BRONSON SOUTH HAVEN HOSPITAL
Active
Other names
Bronson Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MS. REBECCA L EAST (SVP, CFO)
(269) 341-6000
Entity
Organization
Contact information
Practice address
950 S BAILEY AVE, SOUTH HAVEN, MI 49090-8744
(269) 637-5271
(269) 639-2818
Mailing address
601 JOHN ST, BOX 42, KALAMAZOO, MI 49007-5341
(269) 341-8419
(269) 341-8913
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1060000042
MI
207R00000X
Internal Medicine Physician
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
282N00000X
General Acute Care Hospital
800020
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700H06003
BCBS GROUP NUMBER
MI
01
—
800020
LICENSE NUMBER
MI
Enumeration date
04/18/2007
Last updated
11/27/2023
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