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Organization

PORTAGE HEALTH INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES BOGAN (CEO)
(906) 483-1500
Entity
Organization

Contact information

Practice address
500 CAMPUS DR, HANCOCK, MI 49930-1569
(906) 483-1000
Mailing address
500 CAMPUS DR, HANCOCK, MI 49930-1569
(906) 483-1000

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
1060000055
MI
282N00000X
General Acute Care Hospital
Primary
310020
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5171691
MI
01
640C1200
BLUE CROSS AUDIOLOGY GROUP
MI
01
700C16002
BLUE CROSS GROUP
MI
Enumeration date
06/09/2005
Last updated
05/21/2013
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