Provider Demographics
NPI:1073636239
Name:HELEN NEWBERRY JOY HOSPITAL
Entity Type:Organization
Organization Name:HELEN NEWBERRY JOY HOSPITAL
Other - Org Name:GIBSON FAMILY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:EMERY-SHEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-293-9200
Mailing Address - Street 1:502 W HARRIE ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:MI
Mailing Address - Zip Code:49868-1209
Mailing Address - Country:US
Mailing Address - Phone:906-293-9233
Mailing Address - Fax:
Practice Address - Street 1:502 W HARRIE ST
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:MI
Practice Address - Zip Code:49868-1209
Practice Address - Country:US
Practice Address - Phone:906-293-9233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI48-6010261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI48-6010OtherSTATE FACILITY NUMBER
MI233981Medicare Oscar/Certification