Organization
NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION
Active
Other names
Spectrum Health Gerber Memorial
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL J STASIK (PRESIDENT AND CEO)
(231) 924-1340
Entity
Organization
Contact information
Practice address
212 S SULLIVAN ST, FREMONT, MI 49412
(231) 924-1300
(231) 924-1320
Mailing address
212 S SULLIVAN ST, FREMONT, MI 49412
(231) 924-1300
(231) 924-1320
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
—
MI
367500000X
Certified Registered Nurse Anesthetist
620010
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00088
BCBSM
MI
05
—
301557097
—
MI
05
—
405170667
—
MI
01
—
423
PRIORITY HEALTH
MI
05
—
9451
—
MI
Enumeration date
06/22/2005
Last updated
07/21/2022
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