Organization
LAKELAND HOSPITALS AT NILES AND ST JOSEPH, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM CALHOUN (VP FINANCE/CFO)
(269) 983-8300
Entity
Organization
Contact information
Practice address
8 LONG MEADOW VILLAGE DR, NILES, MI 49120-7808
(269) 428-7481
(269) 428-7477
Mailing address
PO BOX 410, SAINT JOSEPH, MI 49085-0410
(269) 428-2574
(269) 428-0490
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
110050
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00219
BLUE CROSS
—
05
—
5236141
—
MI
Enumeration date
09/20/2006
Last updated
04/09/2018
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