Organization
ST JOSEPH HEALTH ENTERPRISES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA SANDFORD (CFO)
(989) 362-8591
Entity
Organization
Contact information
Practice address
410 W M 55, TAWAS CITY, MI 48763-9239
(989) 362-8591
(989) 362-6100
Mailing address
200 HEMLOCK ST, P O BOX 659, TAWAS CITY, MI 48763-9237
(989) 362-8591
(989) 362-6100
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2693001
—
MI
01
—
32665 GRP#39742
COMMUNITY CHOICE OF MI
MI
01
—
540C50277
BLUE CROSS BLUE SHIELD MI
MI
01
—
607014700
USPS DEPT OF LABOR
MI
Enumeration date
12/21/2006
Last updated
06/21/2018
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