Organization
IONIA COUNTY MEMORIAL HOSPITAL CORPORATION
Active
Other names
ICMH HOME CARE
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM ROESER (CHIEF EXECUTIVE OFFICER)
(616) 527-4200
Entity
Organization
Contact information
Practice address
525 LAFAYETTE ST, IONIA, MI 48846-1836
(616) 527-7060
(616) 527-5731
Mailing address
PO BOX 13008, LANSING, MI 48901-3008
(616) 523-1400
(616) 527-5731
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E111
BLUE CROSS BLUE SHIELD
MI
05
—
153173015
—
MI
Enumeration date
06/26/2006
Last updated
07/17/2014
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