Organization
WA FOOTE MEMORIAL HOSPITAL, INC.
Active
Parent organization
WA FOOTE MEMORIAL HOSPITAL, INC.
Other names
Allegiance Home Medical
Organization subpart
Yes
Provider details
NPI number
Legal business name
WA FOOTE MEMORIAL HOSPITAL, INC.
Authorized official
JEANNE' WICKENS (SR. VICE PRESIDENT, FINANCE CFO)
(517) 788-6979
Entity
Organization
Contact information
Practice address
1201 E MICHIGAN AVE, SUITE 110, JACKSON, MI 49201-1852
(517) 817-7638
(517) 817-7636
Mailing address
700 E MICHIGAN AVE, JACKSON, MI 49201-1626
(517) 768-8873
(517) 780-3816
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
380010
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540C801090
BLUE CROSS OF MICHIGAN
MI
Enumeration date
11/19/2009
Last updated
04/05/2011
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