Organization
PORTAGE HEALTH INC
Active
Parent organization
PORTAGE HEALTH INC
Other names
PORTAGE HEALTH DIALYSIS CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
PORTAGE HEALTH INC
Authorized official
MR. JAMES BOGAN (CEO)
(906) 483-1501
Entity
Organization
Contact information
Practice address
500 CAMPUS DR, HANCOCK, MI 49930-1569
(906) 483-1720
(906) 483-1735
Mailing address
500 CAMPUS DR, HANCOCK, MI 49930-1569
(906) 483-1720
(906) 483-1735
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5171691
—
MI
Enumeration date
12/15/2006
Last updated
08/01/2013
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